{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:50:27Z","timestamp":1779360627324,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,1,7]],"date-time":"2023-01-07T00:00:00Z","timestamp":1673049600000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["75D30120C09322"],"award-info":[{"award-number":["75D30120C09322"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Persons experiencing homelessness face increased risk of influenza as overcrowding in congregate shelters can facilitate influenza virus spread. Data regarding on\u2010site influenza testing and antiviral treatment within homeless shelters remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cluster\u2010randomized stepped\u2010wedge trial of point\u2010of\u2010care molecular influenza testing coupled with antiviral treatment with baloxavir or oseltamivir in residents of 14 homeless shelters in Seattle, WA, USA. Residents \u22653\u2009months with cough or \u22652 acute respiratory illness (ARI) symptoms and onset &lt;7\u2009days were eligible. In control periods, mid\u2010nasal swabs were tested for influenza by reverse transcription polymerase chain reaction (RT\u2010PCR). The intervention period included on\u2010site rapid molecular influenza testing and antiviral treatment for influenza\u2010positives if symptom onset was &lt;48\u2009h. The primary endpoint was monthly influenza virus infections in the control versus intervention periods. Influenza whole genome sequencing was performed to assess transmission and antiviral resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 11\/15\/2019\u20134\/30\/2020 and 11\/2\/2020\u20134\/30\/2021, 1283 ARI encounters from 668 participants were observed. Influenza virus was detected in 51 (4%) specimens using RT\u2010PCR (A\u2009=\u200914; B\u2009=\u200937); 21 influenza virus infections were detected from 269 (8%) intervention\u2010eligible encounters by rapid molecular testing and received antiviral treatment. Thirty\u2010seven percent of ARI\u2010participant encounters reported symptom onset\u2009&lt;\u200948\u2009h. The intervention had no effect on influenza virus transmission (adjusted relative risk 1.73, 95% confidence interval [CI] 0.50\u20136.00). Of 23 influenza genomes, 86% of A(H1N1)pdm09 and 81% of B\/Victoria sequences were closely related.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest feasibility of influenza test\u2010and\u2010treat strategies in shelters. Additional studies would help discern an intervention effect during periods of increased influenza activity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.13092","type":"journal-article","created":{"date-parts":[[2023,1,7]],"date-time":"2023-01-07T03:40:46Z","timestamp":1673062846000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Results from a test\u2010and\u2010treat study for influenza among residents of homeless shelters in King County, WA: A stepped\u2010wedge cluster\u2010randomized trial"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3516-7276","authenticated-orcid":false,"given":"Julia H.","family":"Rogers","sequence":"first","affiliation":[{"name":"Division of Allergy and Infectious Diseases, Department of Medicine University of Washington  Seattle Washington USA"},{"name":"Department of Epidemiology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda M.","family":"Casto","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases, Department of Medicine University of Washington  Seattle Washington USA"},{"name":"Vaccine and Infectious Disease Division Fred Hutchinson Cancer Research Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gift","family":"Nwanne","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division Fred Hutchinson Cancer Research Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy C.","family":"Link","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases, Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel A.","family":"Martinez","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases, Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Callista","family":"Nackviseth","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases, Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitlin R.","family":"Wolf","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases, Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division Fred Hutchinson Cancer Research Center  Seattle Washington USA"},{"name":"Department of Biostatistics University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet A.","family":"Englund","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Pediatrics University of Washington, Seattle Children's Research Institute  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Sugg","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy M.","family":"Uyeki","sequence":"additional","affiliation":[{"name":"Influenza Division, National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter D.","family":"Han","sequence":"additional","affiliation":[{"name":"Brotman Baty Institute for Precision Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Pfau","sequence":"additional","affiliation":[{"name":"Brotman Baty Institute for Precision Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Shendure","sequence":"additional","affiliation":[{"name":"Department of Genome Sciences University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8502-9600","authenticated-orcid":false,"given":"Helen Y.","family":"Chu","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases, Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,7]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Disease burden of flu. Centers for Disease Control and Prevention.https:\/\/www.cdc.gov\/flu\/about\/burden\/index.html. Published2022. Accessed October 18 2022."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010126\u20108\u2010199704150\u201000007"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010020\u201005876\u20101"},{"key":"e_1_2_11_5_1","unstructured":"HenryM deSousaT RoddeyC GayenS BednarTJ.The 2020 Annual Homeless Assessment Report (AHAR) to Congrress.2020.https:\/\/www.huduser.gov\/portal\/sites\/default\/files\/pdf\/2020-AHAR-Part-1.pdf"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20102667(20)30053\u20100"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096\u2010020\u201004127\u20109"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6917e1"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02395\u201013"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063\u2010020\u201004871\u20105"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac239"},{"key":"e_1_2_11_12_1","unstructured":"CDC Centers for Diseases Control and Report.Influenza antiviral medications: summary for clinicians. MMWR Morbidity & Mortality Weekly Report.http:\/\/www.cdc.gov\/flu\/professionals\/antivirals\/summary-clinicians.htm. Published2016. 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