Respiratory Syncytial Virus and Other Respiratory Viral Infections in Older Adults With Moderate to Severe Influenza-like Illness

• Published in: The Journal of Infectious Diseases 2014-06, Vol.209 (12), p.1873-1881
• Main Authors: Falsey, Ann R., McElhaney, Janet E., Beran, Jiri, van Essen, Gerrit A., Duval, Xavier, Esen, Meral, Galtier, Florence, Gervais, Pierre, Hwang, Shinn-Jang, Kremsner, Peter, Launay, Odile, Leroux-Roels, Geert, McNeil, Shelly A., Nowakowski, Andrzej, Richardus, Jan Hendrik, Ruiz-Palacios, Guillermo, St Rose, Suzanne, Devaster, Jeanne-Marie, Oostvogels, Lidia, Durviaux, Serge, Taylor, Sylvia
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Aged, 80 and over; Biological and medical sciences; Clinical Trials, Phase III as Topic; Coronavirus; Enterovirus; Female; Fundamental and applied biological sciences. Psychology; Geriatry and gerontology; Hospitalization; Human health and pathology; Human metapneumovirus; Human respiratory syncytial virus; Humans; Infections; Infectious diseases; Influenza A virus; Influenza vaccines; Influenza Vaccines - therapeutic use; Influenza, Human - epidemiology; Life Sciences; Logistic Models; Major and Brief Reports; Male; Medical sciences; Microbiology; Older adults; Pneumonia; Prevalence; Pulmonology and respiratory tract; Randomized Controlled Trials as Topic; Respiratory syncytial virus; Respiratory Syncytial Virus Infections - epidemiology; Respiratory Syncytial Viruses - isolation & purification; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - virology; Reverse Transcriptase Polymerase Chain Reaction; Rhinovirus; Risk Factors; Santé publique et épidémiologie; Surveys and Questionnaires; Viral pneumonia; Viruses
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jit839

Background. Few studies have prospectively assessed viral etiologies of acute respiratory infections in communitybased 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.