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J Infect Dis. 2014 Jun 15;209(12):1873-81. doi: 10.1093/infdis/jit839. Epub 2014 Jan 29.

Respiratory syncytial virus and other respiratory viral infections in older adults with moderate to severe influenza-like illness.

Author information

1
University of Rochester School of Medicine, Rochester General Hospital, Rochester, New York, United States.
2
HSN Volunteer Association Chair in Geriatric Research, Advanced Medical Research Institute of Canada, Sudbury, Ontario, Canada.
3
Vaccination and Travel Medicine Centre, Hradec Kralove, Czech Republic.
4
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
5
Inserm CIC, Hôpital Bichat Claude Bernard National Network of Clinical Investigation in Vaccinology (REIVAC), France.
6
Institut für Tropenmedizin, Tübingen, Germany.
7
National Network of Clinical Investigation in Vaccinology (REIVAC), France Inserm CIC, CHRU de Montpellier, Hôpital Saint Eloi, Montpellier, France.
8
Q&T Research Sherbrooke, Sherbrooke, Quebec, Canada.
9
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan National Yang-Ming University School of Medicine, Taipei, Taiwan.
10
National Network of Clinical Investigation in Vaccinology (REIVAC), France Inserm, CIC BT505 Université Paris Descartes, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Paris Centre, CIC de Vaccinologie Cochin/Pasteur, Paris, France.
11
Centre for Vaccinology, Ghent University and University Hospital, Ghent, Belgium.
12
Canadian Center for Vaccinology and Capital Health, Dalhousie University Health Sciences Centre, Halifax, Nova Scotia, Canada.
13
Family Medicine Centre, Lubartów, Poland Department of Gynaecology and Oncologic Gynaecology, Military Institute of Medicine, Warsaw, Poland.
14
GGD Rotterdam-Rijnmond, Rotterdam, The Netherlands.
15
Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México City, México.
16
GlaxoSmithKline Vaccines, Wavre, Belgium.
17
GlaxoSmithKline Vaccines, Rixensart, Belgium.

Abstract

BACKGROUND:

Few studies have prospectively assessed viral etiologies of acute respiratory infections in community-based elderly individuals. We assessed viral respiratory pathogens in individuals ≥65 years with influenza-like illness (ILI).

METHODS:

Multiplex reverse-transcriptase polymerase chain reaction identified viral pathogens in nasal/throat swabs from 556 episodes of moderate-to-severe ILI, defined as ILI with pneumonia, hospitalization, or maximum daily influenza symptom severity score (ISS) >2. Cases were selected from a randomized trial of an adjuvanted vs nonadjuvanted influenza vaccine conducted in elderly adults from 15 countries.

RESULTS:

Respiratory syncytial virus (RSV) was detected in 7.4% (41/556) moderate-to-severe ILI episodes in elderly adults. Most (39/41) were single infections. There was a significant association between country and RSV detection (P = .004). RSV prevalence was 7.1% (2/28) in ILI with pneumonia, 12.5% (8/64) in ILI with hospitalization, and 6.7% (32/480) in ILI with maximum ISS > 2. Any virus was detected in 320/556 (57.6%) ILI episodes: influenza A (104/556, 18.7%), rhinovirus/enterovirus (82/556, 14.7%), coronavirus and human metapneumovirus (each 32/556, 5.6%).

CONCLUSIONS:

This first global study providing data on RSV disease in ≥65 year-olds confirms that RSV is an important respiratory pathogen in the elderly. Preventative measures such as vaccination could decrease severe respiratory illnesses and complications in the elderly.

KEYWORDS:

elderly; epidemiology; influenza; polymerase chain reaction; prevalence; respiratory infection; respiratory syncytial virus

PMID:
24482398
PMCID:
PMC4038137
DOI:
10.1093/infdis/jit839
[Indexed for MEDLINE]
Free PMC Article

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