Day care and the flu: Using robots, ferrets to explore ways to stop the spread

Three small children play at a table.

New research from Emily Martin

Associate Professor of Epidemiology

Taking advantage of ferrets' social nature, the advancement of robotics and the University of Michigan's extensive experience monitoring respiratory illness in community settings, a new study seeks to better understand how behavioral and environmental factors affect the transmission of respiratory viruses in child care settings.

"When influenza, COVID-19 and other respiratory viruses infect young children, the whole family's life can be disrupted, from parents missing work to children missing opportunities for connection and development," said Emily Martin, one of the lead researchers of the project and associate professor of epidemiology at U-M's School of Public Health.

"We hope this project will find new ways to minimize spread in child care, and reduce the impact of viruses on the day to day lives of families in our community."

Called MITIGATE FLU (Multidisciplinary InvesTIGation to Ease inFLUenza), the project is led by Linsey Marr, professor of civil and environmental engineering at Virginia Tech, and funded by an $8.8 million grant from Flu Lab, an organization that supports bold approaches to defeat influenza.

The U-M team includes researchers from the School of Public Health, Michigan Medicine, Michigan Engineering, and the Department of Ecology and Evolutionary Biology, with researchers from Emory University and University of Pittsburgh also collaborating.

The study is divided into three smaller but interrelated projects, Martin said.

The first one, led by Krista Wigginton, U-M associate professor of civil and environmental engineering, will focus on virus detection in indoor settings by programming iPal robots to interact with children face-to-face while collecting air and surface samples. Later on, the robots will be deployed in six child care centers in southeast Michigan.

As a member of the project led by Wigginton, U-M environmental virologist Melissa Duhaime and her lab will develop viral biomarkers to improve direct measurements of influenza virus in the environment. 

"What we learn will be one part of the equation needed to improve our knowledge of the actual risk of transmission when influenza virus is detected in indoor spaces," said Duhaime, assistant professor of ecology and evolutionary biology.

The second project, led by Seema Lakdawala, associate professor of microbiology and molecular genetics at the University of Pittsburgh, and Anice Lowen, associate professor of microbiology and immunology at Emory University, will use ferrets to evaluate the efficiency of virus transmission modes in spaces similar to day care's play spaces and toys. Michigan Engineering will also play a role in this project, developing environmentally controlled aerosol generation and enclosures for testing transmission.

The third project, co-led by Martin and Andrew Hashikawa, U-M associate professor of pediatric emergency medicine, will look at environmental factors affecting respiratory viruses in day care settings in southeast Michigan. 

The researchers will leverage U-M's extensive work in this area, including the Michigan Child Care Related Infections Surveillance Program and Michigan Public Health's Household Influenza Vaccine Evaluation study. Also participating in this project is Michael Hayashi, clinical assistant professor of epidemiology at the School of Public Health.

"Young children are particularly susceptible to flu and are at higher risk for complications related to flu," Hashikawa said. "I've seen many infants and young children require care in the emergency department at C.S. Mott Children's Hospital for influenza. Some of those children require further hospitalization because of severe flu-related complications, such as severe dehydration or pneumonia." 

Martin said that throughout the COVID-19 pandemic, there have been many questions about what environmental technologies are best to reduce the spread of viruses, especially in child care centers, where children are too young for vaccines and have difficulty wearing masks.

"This is an incredible opportunity to take what we see working in the laboratory and immediately use it to make the classroom environment safer," she said. "This integration is possible by connecting such an exciting team of scientists from so many different fields."

Herek Clack, U-M associate professor of civil and environmental engineering, agreed. 

"This is the dream team and we have the expertise to tackle this research wholeheartedly," he said. "At every one of these intersections or boundaries between disciplines, there are opportunities to close some of the chasms in our understanding of the flu."

U-M's Noah Fromson, Lanard Ingram and Virginia Tech's Courtney Sakry contributed to this report.