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Acute Respiratory Infections

Acute respiratory infections (ARI) are the most common infectious disease syndromes of humans. Among military personnel, the risk and burden of ARI is particularly high. Because of the tremendous impact of ARI outbreaks on training cycles and troop readiness, availability and access to effective treatment and prevention strategies in military populations is critical. Military personnel are routinely immunized for influenza and adenovirus; however, the majority of cases of ARI are caused by pathogens for which licensed vaccines do not currently exist. Moreover, data regarding the epidemiology, immunology and clinical characteristics of common respiratory pathogens, particularly those causing severe disease, are limited.

Key Studies

IDCRP-045: The Acute Respiratory Infection Consortium – A multi-center military consortium for clinical research into the natural history, host response, and potential therapy of acute respiratory infection in military members and their families (ARIC NHS) The Acute Respiratory Infection Consortium (ARIC), established in 2009, is now actively engaged in the analysis of clinical and laboratory data from the ARIC Natural History Study. Numerous manuscripts are in development, with the major objectives to describe the epidemiology and clinical characteristics of influenza-like illness, to evaluate the sensitivity and specificity of new multiplex diagnostic panels, and to assess the impact of antiviral treatment, as well as vaccination, on the clinical course and outcome of influenza infection. The team is in the final stage of development of a standardized symptom severity scale for influenza. Finally, the ARI research area continues its participation in a NIAID-sponsored, multi-center randomized controlled trial of hyperimmune plasma for the treatment of severe influenza.

IDCRP-045-01: Severity symptom grading scale for influenza infection (Flu-PRO) IDCRP-046: Pilot study for collection of anti-influenza A H1N1 (Swine flu) hyper-immune plasma IDCRP-058: Clinical characteristics of novel H1N1 influenza infection in US-based military treatment facilities: A one-year retrospective review IDCRP-062: A randomized, open-label, phase 2, multicenter safety and exploratory efficacy study of investigational anti-influenza A immune plasma for the treatment of influenza

IDCRP-070: Self-administered nasal influenza vaccine: immunogenicity and feasibility of group administration

IDCRP-081: Evaluation of Psychometric Testing Properties of Severity Symptom Grading Scale of Influenza Infection: Flu-Pro Stage III

Military Impact

1. IDCRP developed a multi-site military treatment facility consortium (ARIC) that provides sentinel surveillance for severe ARI and platform for interventional trials

2. Conducts ARI case-control multisite study in military setting

3. Detailed assessment of etiology testing platforms used by DoD

4. Testing feasibility and effectiveness of FluMist self-administration trial (MilVax) for large group vaccination, expanding military surveillance network

5. H1N1 plasma treatment trial across DoD partner commands

Partners and Collaborators

IDCRP collaborates with the National Institute of Allergy and Infectious Diseases (NIAID), Walter Reed Army Institute of Research (WRAIR), Naval Medical Research Center (NMRC), the Armed Forces Health Surveillance Center (AFHSC) Global Emerging Infections Surveillance and Response System (GEIS) and partner military treatment facilities inside and outside the continental United States.

Publications

Chen WJ, Arnold JC, Fairchok MP, et al. Epidemiologic, clinical, and virologic characteristics of human rhinovirus infection among otherwise healthy children and adults: Rhinovirus among adults and children. Journal of Clinical Virology. 2015;64(3):74-82.

Fairchok MP, Chen WJ, Arnold JC, et al. Neuraminidase inhibitor therapy in a military population. Journal of Clinical Virology. 2015;67:17-22.

Reference

Sanchez JL, Cooper MJ, Myers CA, Cummings JF, Vest KG, Russell KL, Sanchez JL, Hiser MJ, Gaydos CA. 17 June 2015. Respiratory infections in the U.S. military: recent experience and control. Clin Microbiol Rev.