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MObile Surveillance for ARI/ILI in the Community (MOSAIC)

Principal Investigator

Melissa Stockwell, MD, MPH
Assistant Professor of Clinical Pediatrics
Department of Pediatrics, College of Physicians & Surgeons of Columbia University

Project Summary

Funder: Centers for Disease Control and Prevention
Grant: U01 IP000618
Dates: September 30, 2012 through September 29, 2017
Funding: $3,750,000

Acute respiratory infections (ARI), including influenza-like illnesses (ILI), can result in significant morbidity and mortality, increased outpatient visits and hospitalizations, and indirect costs from loss of school and work days.1-15 Previous population-based studies have assessed the epidemiology of ARI/ILI, but were conducted as long as 50 years ago.16-19 It is likely that the epidemiology of ARI/ILI has changed since that time as individual and household characteristics have changed.20-24 Moreover, in those studies, a viral pathogen could not be identified in over 75% of ARI/ILI samples.7 Today, modern viral diagnostic techniques such as reverse transcription polymerase chain reaction (RT-PCR) expand our ability to more accurately and completely describe the epidemiology of numerous viral pathogens associated with ARI/ILIs. However, many recent studies using these techniques have focused on one specific viral etiology or assessed ARI/ILI in specific populations, most often patients seeking medical care or hospitalized, rather than taking a broader look at multiple viral pathogens in a community-based sample.25-37 Therefore, a clear need remains to assess the burden of ARI/ILI in a community-based population including identifying the etiology and risk factors for ARI/ILI and transmission. This may be particularly important in low-income communities whose members are at high risk for infection and transmission due to crowded living conditions and who may have decreased access to care.38-39 This study’s purpose was to follow a sample of 300 households (approximately 1000 individuals) representative of an urban, underserved community and identify the incidence, etiology and risk factors associated with ARI/ILI using molecular diagnostic strategies to detect a wide variety of respiratory viral pathogens.

  • Aim 1: Determine incidence of ARI and ILI in a representative population-based community sample.
  • Aim 2: Identify the etiology of ARI and ILI in a population-based community sample.
  • Aim 3: Assess individual and household factors associated with incidence and transmission of ARI/ILI.
  • Secondary Aim 1: Assess differences in epidemiology of ARI/ILI in community study population vs. those seeking acute care.
  • Secondary Aim 2: Determine influenza vaccine effectiveness against laboratory confirmed influenza.



Varghese L, Zachariah P, Vargas C, LaRussa P, Demmer R, Furuya Y, Whittier S, Reed C, Stockwell MS, Saiman L. Epidemiology and Clinical Features of Human Coronaviruses in the Pediatric Population. Journal of the Pediatric Infectious Diseases Society 2017.  [Epub ahead of print.]


Zachariah P, Whittier S, Reed C, LaRussa P, Larson EL, Vargas CY, Saiman L, Stockwell MS. Community-and Hospital Laboratory-Based Surveillance for Respiratory Viruses. Influenza and Other Respiratory Viruses 2016;10(5):361-366.


Vargas CY, Wang L, Castellanos de Belliard Y, Morban M, Diaz H, Larson EL, LaRussa P, Saiman L, Stockwell MS. Pilot study of participant-collected nasal swabs for acute respiratory infections in a low-income, urban population. Clinical Epidemiology 2016;8:1-5.


Smithgall M, Vargas C, Reed C, Finelli L, LaRussa P, Larson E, Saiman L, Stockwell MS. Influenza Vaccine Effectiveness In a Low-Income, Urban Community Cohort.  Clinical Infectious Diseases 2016;62(3):358-360.


Stockwell MS, Reed C, Vargas C, Garretson A, Alba L, LaRussa P, Finelli  L, Larson E, Saiman L. MOSAIC: Mobile Surveillance for ARI and ILl in the Community. American Journal of Epidemiology 2014;180(12):1196-1201.