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J Am Geriatr Soc. 2006 Feb;54(2):284-9.

Two outbreaks of severe respiratory disease in nursing homes associated with rhinovirus.

Author information

1
Respiratory Diseases Branch, National Center for Infectious Diseases, Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. lauriahicks@yahoo.com

Abstract

OBJECTIVES:

To characterize illness and identify the etiology for two nursing home outbreaks of respiratory illness.

DESIGN:

Multisite outbreak investigations; cohort.

SETTING:

Two nursing homes in Pennsylvania.

PARTICIPANTS:

Facility A residents (n = 170), Facility B residents (n = 124), and employees (n = 91).

MEASUREMENTS:

Medical records for Facility A and B residents were reviewed, and employees from Facility B self-administered a questionnaire to identify risk factors for illness. Serological, oropharyngeal, and nasopharyngeal specimens were collected for both outbreaks, and testing for respiratory pathogens was performed.

RESULTS:

In Facility A, 40 (24%) of 170 residents were identified with respiratory illness; 13 (33%) case-patients had radiographically confirmed pneumonia, 15 (38%) were taken to a hospital, and two (5%) died. Of 10 specimens collected from symptomatic Facility A case-patients, four (40%) tested positive using reverse transcription polymerase chain reaction for rhinovirus. In Facility B, 77 (62%) of 124 residents had respiratory illness, and 40 (52%) had radiographically confirmed pneumonia; 12 (16%) case-patients were hospitalized, and five (6%) died. Of 19 respiratory specimens collected from symptomatic Facility B case-patients, six (32%) were positive for rhinovirus; one was from an employee. Five (50%) of 10 rhinovirus-positive cases in both outbreaks had clinical and radiographic evidence of pneumonia.

CONCLUSION:

These investigations suggest that rhinoviruses may be an underrecognized cause of respiratory outbreaks in nursing homes, capable of causing pneumonia and perhaps death.

[Indexed for MEDLINE]

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