CDC RFA-IP-24-045: 2024 Network of Community Cohorts for Monitoring Changes in Respiratory Virus Epidemiology (Pandemic Preparedness Cohorts)

 Limit: 1 // K. Lutrick (Research, Family & Community Medicine) & K. Ellingson (Epidemiology and Biostatistics)

Only one application per institution (normally identified by having a unique entity identifier [UEI] number) is allowed. 

The purpose of this Notice of Funding Opportunity (NOFO) is to establish: 1) a multi-site community-based cohort study that would allow close monitoring of the burden of acute respiratory illness in the community, contributions of various respiratory viruses to this burden, and the impact of vaccination and other interventions on risk of infection and/or severe outcomes, and 2) a case-ascertained household transmission study (or multi-site study) that would support ongoing assessment of transmission dynamics of respiratory viruses of interest and factors (i.e., demographic, clinical, or household-level factors) that may impact transmission.

While hospital-based platforms are key to assessing frequency and risk factors for severe disease, community-based platforms are essential for understanding age-specific incidences of infection, risk factors for infection, socioeconomic burden of infections (such as days of work/school lost), and the clinical spectrum of illness. They are important for characterizing the immune response to infection or reinfection and long-term outcomes, and they are key to understanding the impact of individual- and household-level mitigation factors (including but not limited to vaccination) on all of these measures. This type of network may be especially useful for detecting changes in any of these factors when a new virus or viral variant begins circulating.

Case-ascertained household transmission studies are well-positioned to quickly and efficiently enable us to understand transmission dynamics of respiratory viruses (or sublineages/types of existing viruses that undergo frequent mutation, such as SARS-CoV-2 and influenza) and assess potential mitigation factors. These studies can also be valuable for characterizing viral shedding dynamics and infectiousness. These studies were key during the COVID-19 pandemic to understanding if changes in hospitalization rates were due to changes in transmissibility/infection rates versus changes in severity of illness. They are also great resources for assessing how history of vaccination or prior history of infection effect transmission to close contacts.

This NOFO would build on the lessons learned during the COVID-19 pandemic and establish a consolidated network of community cohorts to monitor a range of respiratory viruses among community members who develop symptoms of acute respiratory illness. Incorporation of multi-pathogen testing will allow us to better understand the relative contribution of various viruses to the overall community burden of respiratory disease now in the post-pandemic setting, and how the clinical spectrum of these illnesses compare, in a setting in which multiple new preventive products are becoming available. This would also support the establishment of a case-ascertained transmission study (or multi-site study) that would be able to assess SARS-CoV-2, Respiratory Syncytial Virus (RSV), and other prioritized respiratory viruses on an ongoing basis.

The combination of these studies will generate much greater visibility on risk factors for infection and the effectiveness of various interventions in reducing infections and viral transmission, factors that are relevant to reducing overall morbidity and mortality related to respiratory viruses. Should a new variant or virus arrive, this platform would be well positioned to further expand testing to better understand potential concerns like proportion symptomatic, timing of transmission, likelihood of asymptomatic transmission and other related questions. Such questions may be key to developing public health guidance should additional mitigation measures become necessary.