ORCHARDS-AIR Study

The purpose of ORCHARDS-AIR is to utilize air surveillance in participant homes in conjunction with individually collected nasal specimens to assess their concordance and evaluate the significance of airborne detection with household transmission of common respiratory pathogens such as influenza and SARS-CoV-2.

The researchers postulate that households with documented and probable respiratory pathogen transmission will have higher rates of in-home air surveillance detection. Students with more severe illnesses will be absent more often and spend more time at home, potentially leading to absenteeism being associated with greater air surveillance detections and intrahousehold transmission.

• Nasal swab (Diagnostic test): Participants will use a swab to collect nasal specimens
• Indoor air quality monitor (Device): InBio Apollo ambient air sampler to be run in the home for the duration of study participation. Material from the air, like aerosols, dust particles, and other environmental material, are collected on sampler filler material.

Primary outcomes

• Rate of virus detection [Day 0, Day 7, Day 14]: Participants will provide nasal swabs, which will be tested for a panel of viruses.
• Rate of air sampling detection among families with documented transmission [Day 7, Day 14]: Study team will collect and test air sampler filter for viruses.
• Rate of air sampling detection among families without documented transmission [Day 7, Day 14]: Study team will collect and test air sampler filter for viruses.
• Survey of symptoms - day 0 [Day 0]: Qualitative survey of participants' symptoms and related activities.
• Survey of symptoms - day 7 [Day 7]: Qualitative survey of participants' symptoms and related activities.
• Survey of symptoms - day 14 [Day 14]: Qualitative survey of participants' symptoms and related activities.
• Air sampler use survey [Day 7, Day 14]: Qualitative survey about participants' use of the air sampler.

Secondary outcomes

• Number of absences [14 days]: Participants will self-report whether they were absent from school during the study period.

Sex: All, ages: 4 Years to any

Inclusion Criteria - Students:

* Student attends, or is eligible to attend, a school within the Oregon School District (OSD)
* Study has an illness characterized by at least 2 of 6 acute respiratory infection (ARI)/ILI symptoms (nasal discharge, nasal congestion, sneezing, sore throat, cough, fever) and student scores at least 2 points on the Jackson scale

Exclusion Criteria - Students:

* Household member listed on Wisconsin Department of Corrections Sex Offender Registry
* Illness onset more than 7 days before anticipated time of specimen collection
* Anatomical defect for which nasal specimen collection is contraindicated
* Student participated too recently (<7 days from day 14 during peak influenza / COVID-19 period and <30 days during other times, as determined by a medically-attended surveillance program)

Inclusion Criteria - Household member:

* Live in the same household as eligible student participant
* Any age and gender
* Fluent in English
* Able to provide appropriate consent or assent

• Jonathan Temte, MD, PhD, Principal investigator, University of Wisconsin, Madison