Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Codetection With Influenza A and Other Respiratory Viruses Among School-Aged Children and Their Household Members-12 March 2020 to 22 February 2022, Dane County, Wisconsin.

BACKGROUND: Concurrent detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and another respiratory virus in individuals can document contemporaneous circulation. We used an ongoing, community-based study of school-aged children and their households to evaluate SARS-CoV-2 codetections with other respiratory viruses in a non-medically attended population over a 2-year period. METHODS: Household enrollment was predicated on an acute respiratory illness in a child residing in that household who was also a kindergarten through 12th-grade student in the participating school district. Demographic, symptom, and household composition data and self-collected nasal specimens were obtained on the recruitment day, and 7 and 14 days later, from the index child and all other household members. All specimens were tested for SARS-CoV-2 and influenza A/B by reverse-transcription polymerase chain reaction. Day 0 specimens from the index children were simultaneously tested for 16 pathogens using a commercial respiratory pathogen panel (RPP). To assess viral codetections involving SARS-CoV-2, all household specimens were tested via RPP if the index child's day 0 specimen tested positive to any of the 16 pathogen targets in RPP and any household member tested positive for SARS-CoV-2. RESULTS: Of 2109 participants (497 index children in 497 households with 1612 additional household members), 2 (0.1%) were positive for both SARS-CoV-2 and influenza A; an additional 11 (0.5%) were positive for SARS-CoV-2 and another RPP-covered respiratory virus. Codetections predominantly affected school-aged children (12 of 13 total) and were noted in 11 of 497 households. CONCLUSIONS: SARS-CoV-2 codetections with other respiratory viruses were uncommon and predominated in school-aged children.

Surveillance of SARS-CoV-2 in Asymptomatic Faculty and Staff at the University of Wisconsin-Madison.

INTRODUCTION: Surveillance of SARS-CoV-2 among university employees is an important part of mitigation strategies to prevent asymptomatic transmission and ensure a safe learning and work environment. Here, we assess the feasibility and performance of a program that relies on monitored self-collected nasal swabs to detect SARS-CoV-2 among asymptomatic faculty and staff. METHODS: We recruited 1,030 faculty and staff via rolling enrollment who completed the required University of Wisconsin-Madison employee COVID-19 training and reported working on campus. Asymptomatic participants visited a designated location during a specified timeframe each week where they self-collected nasal swabs supervised by study staff. Specimens were stored in a cooler between 2 °C and 8 °C, then transported to the Wisconsin Veterinary Diagnostic Laboratory for polymerase chain reaction testing. Symptomatic participants or participants with a known exposure were advised to test elsewhere and follow quarantine guidelines from the Centers for Disease Control and Prevention. RESULTS: Over the course of 31 weeks, 1,030 participants self-collected 17,323 monitored nasal swabs resulting in high participation (90%). SARS-CoV-2 was detected in 16 specimens. Eight specimens were inconclusive but were treated as positive results because of the implied detection of 1 or more SARS-CoV-2 genes. There were no invalid tests. Weekly SARS-CoV-2 incidence among participants ranged from 0 to 1.54% (x̄ = 0.20%). The SARS-CoV-2 incidence among participants was similar to estimated incidence in the greater university employee population. CONCLUSION: Weekly SARS-CoV-2 surveillance of asymptomatic faculty and staff on campus allowed for estimation of weekly SARS-CoV-2 incidence among on-campus employees. This surveillance protocol presents a low-cost, effective, and scalable option to identify asymptomatic cases of SARS-CoV-2 among university employees.

Cause-specific student absenteeism monitoring in K-12 schools for detection of increased influenza activity in the surrounding community-Dane County, Wisconsin, 2014-2020.

BACKGROUND: Schools are primary venues of influenza amplification with secondary spread to communities. We assessed K-12 student absenteeism monitoring as a means for early detection of influenza activity in the community. MATERIALS AND METHODS: Between September 2014 and March 2020, we conducted a prospective observational study of all-cause (a-TOT), illness-associated (a-I), and influenza-like illness-associated (a-ILI) absenteeism within the Oregon School District (OSD), Dane County, Wisconsin. Absenteeism was reported through the electronic student information system. Students were visited at home where pharyngeal specimens were collected for influenza RT-PCR testing. Surveillance of medically-attended laboratory-confirmed influenza (MAI) occurred in five primary care clinics in and adjoining the OSD. Poisson general additive log linear regression models of daily counts of absenteeism and MAI were compared using correlation analysis. FINDINGS: Influenza was detected in 723 of 2,378 visited students, and in 1,327 of 4,903 MAI patients. Over six influenza seasons, a-ILI was significantly correlated with MAI in the community (r = 0.57; 95% CI: 0.53-0.63) with a one-day lead time and a-I was significantly correlated with MAI in the community (r = 0.49; 0.44-0.54) with a 10-day lead time, while a-TOT performed poorly (r = 0.27; 0.21-0.33), following MAI by six days. DISCUSSION: Surveillance using cause-specific absenteeism was feasible and performed well over a study period marked by diverse presentations of seasonal influenza. Monitoring a-I and a-ILI can provide early warning of seasonal influenza in time for community mitigation efforts.

Evaluation of Viruses Associated With Acute Respiratory Infections in Long-Term Care Facilities Using a Novel Method: Wisconsin, 2016‒2019.

Residents of long-term care facilities (LCTFs) have high morbidity and mortality associated with acute respiratory infections (ARIs). Limited information exists on the virology of ARI in LTCFs, where virological testing is reactive. We report on findings of a surveillance feasibility substudy from a larger prospective trial of introducing rapid influenza diagnostic testing (RIDT) at 10 Wisconsin LTCFs. Any resident with symptoms consistent with ARI had a nasal swab specimen collected for RIDT by staff. Following RIDT, the residual swab was placed into viral transport medium and tested for influenza using Reverse transcription polymerase chain reaction, and for 20 pathogens using a multiplex polymerase chain reaction respiratory pathogen panel. Numbers of viruses in each of 7 categories (influenza A, influenza B, coronaviruses, human metapneumovirus, parainfluenza, respiratory syncytial virus, and rhinovirus/enterovirus) across the 3 years were compared using χ2. Totals of 160, 215, and 122 specimens were collected during 2016‒2017, 2017‒2018, and 2018‒2019, respectively. Respiratory pathogen panel identified viruses in 54.8% of tested specimens. Influenza A (19.2%), influenza B (12.6%), respiratory syncytial virus (15.9%), and human metapneumovirus (20.9%) accounted for 69% of all detections, whereas coronaviruses (17.2%), rhinovirus/enterovirus (10.5%) and parainfluenza (3.8%) were less common. The distribution of viruses varied significantly across the 3 years (χ2 = 71.663; df = 12; P < .001). Surveillance in LTCFs using nasal swabs collected for RIDT is highly feasible and yields high virus identification rates. Significant differences in virus composition occurred across the 3 study years. Simple approaches to surveillance may provide a more comprehensive assessment of respiratory viruses in LTCF settings.

Managing Close Contacts of COVID-19 Confirmed Cases in Metropolitan Areas in China.

The novel coronavirus (COVID-19) outbreak has rapidly spread across the world. As medical systems continue to develop vaccines and treatments, it is crucial for the public health community to establish nonpharmaceutical interventions (NPIs) that can effectively mitigate the rate of SARS-Coronavirus-2 (SARS-CoV-2) spread across highly populated residential areas, especially among individuals who have close contact with confirmed cases. A community-driven preparedness strategy has been implemented in metropolitan areas in China. The Chinese Center for Disease Control and Prevention (CCDC) has required that all COVID-19 confirmed cases be recorded and documented in a national notifiable disease surveillance system (NDSS). After receiving reports of newly confirmed cases, an epidemiological services team at the CCDC or trained medical professionals at local clinical facilities start a case-contact investigation. A task force performs home visits to infected individuals. Persons under investigation (PUIs) can stay in designated quarantine facilities for 14 days or in special circumstances can be quarantined at home. This community-based approach involved all stakeholders including local public health departments, public safety authorities, neighborhood councils, and community health centers.