A rhinovirus outbreak among residents of a long-term care facility.
OBJECTIVE
To describe the epidemiology of and clinical findings associated with a rhinovirus outbreak that occurred among institutionalized elderly persons.


METHODS
Retrospective review of medical records and nursing surveillance reports.


METHODS
A 685-bed, long-term care facility for veterans and their spouses.


METHODS
33 persons from whom rhinovirus was cultured.


METHODS
Throat and nasopharyngeal virus culture; review of medical records to determine underlying diseases, signs and symptoms of respiratory illness, illness duration, and interventions during illness; and review of nursing surveillance reports to determine room locations of ill persons.


RESULTS
Between 14 August and 2 September 1993, the number of respiratory illnesses increased. Throat and nasopharyngeal virus cultures were taken from 67 ill residents; 33 cultures yielded rhinovirus, and no other respiratory virus was isolated. Geographic clustering of persons infected with rhinovirus was observed. Of those persons with rhinovirus infections, 100% had upper respiratory symptoms, 34% had gastrointestinal symptoms, 71% had systemic symptoms, 66% had lower respiratory symptoms (including productive cough), and 52% had new abnormalities on lung auscultation. The 17 persons with rhinovirus infection who had chronic obstructive pulmonary disease had more severe illnesses: Five (29%) required glucocorticoid or bronchodilator therapy for illness-associated bronchospasm; 2 required transfer out of the facility; 1 developed a radiographically documented infiltrate; and 1 died of respiratory failure.


CONCLUSIONS
Rhinovirus may cause epidemic, clinically important respiratory illness in nursing homes residents. A large proportion of residents may become ill, and infection may be severe in persons with underlying lung disease.
Wald
T G
TG
University of Wisconsin Medical School, Madison, USA.
Shult
P
P
Krause
P
P
Miller
B A
BA
Drinka
P
P
Gravenstein
S
S
D000368:Aged; D016000:Cluster Analysis; D004196:Disease Outbreaks; D006707:Homes for the Aged; D006801:Humans; D008171:Lung Diseases / Q000150:complications; D010850:Picornaviridae Infections / Q000150:complications / Q000453:epidemiology*; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D012189:Retrospective Studies; D012229:Rhinovirus; D014922:Wisconsin / Q000453:epidemiology