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BMC Infect Dis. 2018 Nov 6;18(1):550. doi: 10.1186/s12879-018-3444-7.

Study of Healthcare Personnel with Influenza and other Respiratory Viruses in Israel (SHIRI): study protocol.

Author information

1
Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel. avitalhi@clalit.org.il.
2
Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.
3
School of Public Health, Medical School for International Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
4
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
5
Rabin Medical Center, Occupational Medicine Department, Petah Tikva, Israel.
6
Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel.
7
Abt Associates, Inc, Atlanta, GA, USA.
8
Clinical Virology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.
9
Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
10
Department of Microbiology Immunology and Genetics, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
11
Vaccine and Infectious Disease Division, Fred Hutch Cancer Research Center, Seattle, WA, USA.
12
Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel.
13
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
14
Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
15
U.S. Naval Medical Research Unit N° 6 - Lima, Lima, Peru.

Abstract

BACKGROUND:

The Study of Healthcare Personnel with Influenza and other Respiratory Viruses in Israel (SHIRI) prospectively follows a cohort of healthcare personnel (HCP) in two hospitals in Israel. SHIRI will describe the frequency of influenza virus infections among HCP, identify predictors of vaccine acceptance, examine how repeated influenza vaccination may modify immunogenicity, and evaluate influenza vaccine effectiveness in preventing influenza illness and missed work.

METHODS:

Cohort enrollment began in October, 2016; a second year of the study and a second wave of cohort enrollment began in June 2017. The study will run for at least 3 years and will follow approximately 2000 HCP (who are both employees and members of Clalit Health Services [CHS]) with routine direct patient contact. Eligible HCP are recruited using a stratified sampling strategy. After informed consent, participants complete a brief enrollment survey with questions about occupational responsibilities and knowledge, attitudes, and practices about influenza vaccines. Blood samples are collected at enrollment and at the end of influenza season; HCP who choose to be vaccinated contribute additional blood one month after vaccination. During the influenza season, participants receive twice-weekly short message service (SMS) messages asking them if they have acute respiratory illness or febrile illness (ARFI) symptoms. Ill participants receive follow-up SMS messages to confirm illness symptoms and duration and are asked to self-collect a nasal swab. Information on socio-economic characteristics, current and past medical conditions, medical care utilization and vaccination history is extracted from the CHS database. Information about missed work due to illness is obtained by self-report and from employee records. Respiratory specimens from self-collected nasal swabs are tested for influenza A and B viruses, respiratory syncytial virus, human metapneumovirus, and coronaviruses using validated multiplex quantitative real-time reverse transcription polymerase chain reaction assays. The hemagglutination inhibition assay will be used to detect the presence of neutralizing influenza antibodies in serum.

DISCUSSION:

SHIRI will expand our knowledge of the burden of respiratory viral infections among HCP and the effectiveness of current and repeated annual influenza vaccination in preventing influenza illness, medical utilization, and missed workdays among HCP who are in direct contact with patients.

TRIAL REGISTRATION:

NCT03331991 . Registered on November 6, 2017.

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