Opportunity Information: Apply for RFA IP 10 007
Apply for RFA IP 10 007
- The Centers for Disease Control and Prevention in the health sector is offering a public funding opportunity titled "Effectiveness of Empiric Antiviral Treatment for Hospitalized Community Acquired Pneumonia during the Influenza Season (U18)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.185 Immunization Research, Demonstration, Public Information and EducationTraining and Clinical Skills Improvement Projects.
- This funding opportunity was created on Apr 26, 2010 and posted on Mar 1, 2010.
- Applicants must submit their applications by May 3, 2010 Letter of Intent Receipt Date March 29, 2010 Application Submission Receipt Date May 3, 2010. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $1,500,000.00 to eligible and selected applicants.
- Each selected applicant is eligible to receive up to $1,000,000.00 in funding.
- The number of recipients for this funding is limited to 2 candidate(s).
- Eligible applicants include: Others (see text field entitled Additional Information on Eligibility for clarification).
- Eligible Institutions You may submit an application(s) if your organization has any of the following characteristics Public nonprofit organizations Private nonprofit organizations Universities Colleges Research institutions Hospitals Community based organizations Faith based organizations Federally recognized or state recognized American Indian/Alaska Native tribal governments American Indian/Alaska Native tribally designated organizations Alaska Native health corporations Urban Indian health organizations Tribal epidemiology centers State and local governments or their Bona Fide Agents (this includes the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of the Northern Marianna Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau) Political subdivisions of States (in consultation with States) Foreign Institutions A Bona Fide Agent is an agency/organization identified by the state as eligible to submit an application under the state eligibility in lieu of a state application. If you are applying as a bona fide agent of a state or local government, you must provide a letter from the state or local government as documentation of your status. Attach this documentation behind the first page of your application form or for electronic applications, use a PDF file and attach as Other Documents and label as appropriate.
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Opportunity Summary:
The CDC cooperative agreement titled "Effectiveness of Empiric Antiviral Treatment for Hospitalized Community Acquired Pneumonia during the Influenza Season (U18)" focuses on a practical gap in how adult community acquired pneumonia (CAP) is treated in hospitals when influenza is circulating. Standard CAP guidelines push clinicians to start broad spectrum antibiotics right away, without waiting for proof of a bacterial cause, because earlier etiology studies show bacterial pathogens are common and delayed treatment can worsen outcomes. At the same time, even though multiple studies have shown influenza is also an important cause of pneumonia severe enough to require hospitalization, especially during peak flu season, antivirals are not routinely started unless influenza is confirmed. The core purpose of this opportunity is to support work that tests whether it makes sense to treat hospitalized CAP patients with empiric antivirals alongside empiric antibiotics during influenza season, rather than waiting for test results that may arrive late or be inaccurate.
The public health and clinical rationale is based on several real-world limitations of influenza testing and timing. In many hospitals, clinicians do not routinely test all CAP patients for influenza, and when testing is performed it often relies on rapid antigen assays that are known to have low sensitivity. More sensitive approaches like RT-PCR are not always readily available in routine care, and even when they are available, results may take days. That delay matters because antivirals such as neuraminidase inhibitors are most effective when started early in the course of influenza illness; the later they are initiated, the smaller the expected benefit. The announcement also notes that RT-PCR on respiratory specimens is not perfect for detecting influenza in every situation, and it points to evidence from Thailand suggesting that a meaningful proportion of acute influenza infections can be missed unless serology is added, with studies identifying an additional 10 to 20 percent of cases beyond RT-PCR testing of nasopharyngeal specimens. Taken together, these points build the argument that a "test then treat" approach may fail many hospitalized patients who actually have influenza-associated pneumonia, and that empiric antiviral therapy might improve outcomes during periods of community influenza circulation.
The urgency of the question is reinforced by experience with novel influenza A (H1N1), where extensive autopsy testing in fatal cases documented primary viral pneumonia in the majority of deaths. That observation underscores that influenza is not just a trigger for secondary bacterial pneumonia; it can directly cause severe viral pneumonia, meaning that antibiotics alone may not address the main driver of illness in a significant subset of hospitalized CAP cases during flu season. The opportunity therefore aims to generate stronger evidence to guide clinicians on whether empiric antivirals should become a more routine part of CAP management when influenza is likely, similar to how empiric antibiotics are routinely started based on epidemiologic expectations rather than confirmed bacterial culture.
From a funding and administrative standpoint, this was a discretionary CDC funding opportunity using a cooperative agreement mechanism (U18), meaning recipients would likely work in close collaboration with CDC on study design, implementation, and reporting rather than operating entirely independently. The program planned to make about two awards, with an estimated total funding of $1.5 million and an award ceiling of $1 million per award, with no cost sharing or matching requirement. The opportunity was posted March 1, 2010, with a letter of intent due March 29, 2010, and the final application receipt date listed as May 3, 2010 (after an extension from the original April 26 deadline). The CFDA listing included 93.185 (Immunization Research, Demonstration, Public Information and Education) and Training and Clinical Skills Improvement Projects, reflecting the intersection of applied infectious disease research and improved clinical practice.
Eligibility was broad and included public and private nonprofits, universities and colleges, research institutions, hospitals, community-based and faith-based organizations, tribal governments and tribal health organizations, tribal epidemiology centers, state and local governments (including US territories and freely associated states listed in the announcement), political subdivisions of states in consultation with states, and foreign institutions. The announcement also explains that bona fide agents may apply on behalf of a state or local government, but they must provide documentation (a letter from the state or local government) verifying that status. For organizations needing help accessing the full announcement, CDC Procurement and Grants Office TIMS was listed as the point of contact (770-488-2700; PGOTIM@cdc.gov).
Overall, the grant opportunity is essentially about improving pneumonia care during influenza season by answering a straightforward but high-impact question: when a hospitalized adult presents with CAP while influenza is circulating, does starting antiviral therapy empirically, alongside standard empiric antibiotics, lead to better outcomes than the common practice of waiting for influenza confirmation that may never come or may come too late to matter.
FAQs: Effectiveness of Empiric Antiviral Treatment for Hospitalized Community Acquired Pneumonia during the Influenza Season (U18)
What is the main goal of this CDC cooperative agreement?
The opportunity supports work to determine whether hospitalized adults with community acquired pneumonia (CAP) should receive empiric antiviral treatment during influenza season at the same time they receive standard empiric antibiotics, rather than waiting for influenza test confirmation that may be delayed or inaccurate.
What clinical problem is this funding opportunity trying to address?
In routine hospital practice, CAP guidelines emphasize starting broad spectrum antibiotics immediately, even before a bacterial cause is confirmed. During influenza season, influenza can also be an important cause of pneumonia severe enough to require hospitalization, but antivirals are often not started unless influenza is confirmed by testing. This creates a practical gap in care when influenza is circulating.
Why does the announcement focus on empiric antivirals during influenza season?
The rationale is that a "test then treat" approach can miss or delay treatment for patients who actually have influenza-associated pneumonia. Antivirals such as neuraminidase inhibitors are most effective when started early in the course of illness, so delays in testing or low test sensitivity can reduce potential benefit.
What does "empiric antiviral treatment" mean in this context?
It means starting antiviral therapy based on the likelihood of influenza being present in the community (influenza season) and the patient presentation (hospitalized CAP), rather than waiting for laboratory confirmation of influenza.
How is CAP typically treated in hospitals according to the problem statement?
CAP is commonly treated with empiric broad spectrum antibiotics started right away, without waiting for proof of a bacterial cause, because earlier studies found bacterial pathogens to be common and because delaying treatment can worsen outcomes.
Why might relying on influenza testing not be enough in hospitalized CAP cases?
The announcement highlights multiple limitations: not all hospitals routinely test all CAP patients for influenza; rapid antigen assays commonly used in practice have low sensitivity; RT-PCR may not be readily available in routine care; and even when RT-PCR is available, results may take days. These issues can lead to missed or late diagnoses and delayed antiviral initiation.
What testing limitations are described for rapid influenza antigen assays?
The opportunity notes that rapid antigen assays are known to have low sensitivity, meaning they can miss true influenza infections.
What testing limitations are described for RT-PCR?
RT-PCR is described as more sensitive than rapid antigen testing but not always readily available in routine care. When available, results may take days. The announcement also notes RT-PCR on respiratory specimens is not perfect for detecting influenza in every situation.
What additional evidence is mentioned about missed influenza cases beyond RT-PCR?
The announcement points to evidence from Thailand indicating that a meaningful proportion of acute influenza infections can be missed unless serology is added, with studies identifying an additional 10 to 20 percent of cases beyond RT-PCR testing of nasopharyngeal specimens.
Why is timing of antiviral treatment emphasized?
The announcement states that antivirals such as neuraminidase inhibitors are most effective when started early in influenza illness, and the later they are initiated, the smaller the expected benefit. Testing delays therefore matter clinically.
How does the experience with novel influenza A (H1N1) relate to this opportunity?
The announcement cites extensive autopsy testing in fatal H1N1 cases showing primary viral pneumonia in the majority of deaths. This supports the idea that influenza can directly cause severe viral pneumonia (not only secondary bacterial pneumonia), and antibiotics alone may not address the main driver of illness in a subset of hospitalized CAP cases during influenza season.
What key research question is this opportunity trying to answer?
When a hospitalized adult presents with CAP while influenza is circulating, does starting antiviral therapy empirically alongside standard empiric antibiotics lead to better outcomes than waiting for influenza confirmation that may be delayed, inaccurate, or never obtained?
What type of funding mechanism is used for this opportunity?
This is a CDC cooperative agreement using the U18 mechanism.
What does a cooperative agreement (U18) imply about CDC involvement?
The description indicates recipients would likely work in close collaboration with CDC on study design, implementation, and reporting, rather than operating entirely independently.
How many awards were expected and how much funding was planned?
The program planned to make about two awards, with an estimated total funding of $1.5 million.
What was the maximum award amount (award ceiling)?
The award ceiling was listed as $1 million per award.
Was cost sharing or matching required?
No cost sharing or matching requirement was stated.
When was the opportunity posted and what were the key deadlines?
The opportunity was posted March 1, 2010. The letter of intent was due March 29, 2010. The final application receipt date was May 3, 2010, following an extension from the original April 26 deadline.
What CFDA listing(s) were associated with this opportunity?
The CFDA listing included 93.185 (Immunization Research, Demonstration, Public Information and Education) and Training and Clinical Skills Improvement Projects.
Who was eligible to apply?
Eligibility was broad and included public and private nonprofits, universities and colleges, research institutions, hospitals, community-based and faith-based organizations, tribal governments and tribal health organizations, tribal epidemiology centers, state and local governments (including US territories and freely associated states listed in the announcement), political subdivisions of states in consultation with states, and foreign institutions.
Can a bona fide agent apply on behalf of a state or local government?
Yes. The announcement states that bona fide agents may apply on behalf of a state or local government, but they must provide documentation (a letter from the state or local government) verifying that status.
Who was the point of contact for help accessing the full announcement?
CDC Procurement and Grants Office TIMS was listed as the point of contact: 770-488-2700; PGOTIM@cdc.gov.
What practical change in hospital pneumonia care is this opportunity evaluating?
It evaluates whether empiric antivirals should become a more routine part of CAP management during influenza season, similar to how empiric antibiotics are routinely started based on epidemiologic expectations rather than confirmed bacterial culture.
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