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. 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

Ann R Falsey  1 , Janet E McElhaney  2 , Jiri Beran  3 , Gerrit A van Essen  4 , Xavier Duval  5 , Meral Esen  6 , Florence Galtier  7 , Pierre Gervais  8 , Shinn-Jang Hwang  9 , Peter Kremsner  6 , Odile Launay  10 , Geert Leroux-Roels  11 , Shelly A McNeil  12 , Andrzej Nowakowski  13 , Jan Hendrik Richardus  14 , Guillermo Ruiz-Palacios  15 , Suzanne St Rose  16 , Jeanne-Marie Devaster  17 , Lidia Oostvogels  16 , Serge Durviaux  16 , Sylvia Taylor  16
Affiliations

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

Ann R Falsey et al. J Infect Dis. .

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.

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