Background and Objectives:
The epidemiological relevance of viral acute respiratory infections (VARIs) has been dramatically highlighted by COVID19, but other viruses cannot be neglected, such as influenza virus, respiratory syncytial virus, rhinovirus, other coronavirus, adenovirus, metapneumovirus. The transmission of these viruses occurs mainly in closed spaces and is dependent both on human and environmental factors. Besides schools, closed communities, such as nursing homes and prisons are the most vulnerable settings, where the real extent of VARIs is often difficult to evaluate, due to the natural history of the diseases and to case ascertainment. In the COVID19 pandemic the Wastewater Based surveillance has shown its great potential for monitoring the virus diffusion and evolution in the environment. Our aim is to pilot an integrated surveillance system for closed communities, carried out through a syndromic surveillance, environmental monitoring (air, surfaces, and wastewater), and the collection on environmental and behavioral risk factors.

Methods:
The Project funded by the National Recovery and Resilience Plan NRRP - Tuscany Health Ecosystem will consists in design and validate tools for epidemiological and environmental surveillance and analytical methods for environmental matrices, including viral sensors for viruses detection. The integration of all these information into risk assessment models will provide a useful tool for early warning and risk management.

Results:
In the first phase of the project we will design and validate tools, such as clinical, epidemiological and environmental-based questionnaires, for each setting coupled with analytical methods for viruses’ detection. The integrated surveillance system for closed communities, will be carry-out through syndromic surveillance, environmental monitoring (air, surfaces, and wastewater) and collection of environmental risk factors.

Conclusion:
Integrating different surveillance systems for VARIs appears crucial to inform early warning and risk assessment tools available at local, regional and National level, but methods and strategies need to be set up.