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Background: The epidemiology of medically attended respiratory viral infections (RVI) is well described, however, the epidemiology of RVI in schools is poorly understood. The goal of our School KIDS study, an ongoing surveillance program, is to understand the epidemiology of respiratory viral pathogens in asymptomatic and symptomatic students/staff and to understand the vaccine effectiveness for COVID-19 and influenza in K-12 schools in order to inform public health.

Methods: School KIDS is being conducted in the North Kansas City School District (NKC) and is underway; open to all students and staff, with enrollment starting from October 31, 2022. Participants with respiratory symptoms can self-collect a nasal swab at home/school and send it to Children's Mercy. Two follow-up nasal swabs, convalescent samples, are collected one and two weeks after the initial symptomatic test. Symptomatic samples are tested by the QIAstat-Dx Respiratory SARS-CoV-2 Panel; asymptomatic and convalescent samples are tested by the fully automated Hologic Panther Fusion system.

Results: From November 01, 2022, to February 24, 2023, 298 symptomatic subjects (70 staff and 228 students) were tested; female (191, 64.09%) and males (93, 31.21%). 213 (71.48%) identified as white, 39 (13.09%) Hispanic, 12 (4.03%) black. 140 (46.98%) elementary school aged, 31 (10.40%) high-school, 48 (16.1%) middle-school and 9 (3.0%) Pre-K. Of 467 symptomatic samples tested 233 (49.89%) and 23 (4.93%) samples were positive for 1 virus and >1 virus respectively; 234 (50.11%) where negative. Rhinovirus/Enterovirus, 73, (28.52%) and seasonal coronaviruses, 63, (13.49%) were the top 2 targets detected. Detailed distribution of viral targets is tabulated in Table 1. Of the 190 total convalescent samples tested, 49 (25.79%) were negative following their positive symptomatic counterpart; (32, 16.84%) were positive following their positive symptomatic counterparts with either the same virus (19, 10.00%) or a different virus (13, 6.84%) being detected. 6 samples (3.16%) tested positive following a negative result for their symptomatic counterpart.

Conclusion: Overall, there is a 49.89% detection rate in symptomatic subjects and a 24.74% detection rate in convalescent samples, with rhinovirus and seasonal coronaviruses being the predominant RVI in school-going children. Most RVI surveillance in children is done in medical settings, but this may not accurately represent the prevalence of infections in children who aren't under medical care. In-school COVID-19 testing has provided current data on infection rates and transmission that may differ from community rates. Expanding RVI testing beyond COVID-19 in schools could provide important information to better understand virus epidemiology in K-12 schools.

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Respiratory Viral Infections in School KIDS