Acute viral infections of upper respiratory tract in elderly people living in the community: comparative, prospective, population based study of disease burden.
OBJECTIVE
To evaluate the disease burden of upper respiratory infections in elderly people living at home.


METHODS
Prospective surveillance of elderly people.


METHODS
None.


METHODS
Leicestershire, England


METHODS
533 subjects 60 to 90 years of age.


METHODS
Pathogens, symptoms, restriction of activity, duration of illness, medical consultations, interval between onset of illness and medical consultation, antibiotic use, admission to hospital, and death.


RESULTS
231 pathogens were identified for 211 (43%) of 497 episodes for which diagnostic specimens were available: 121 (52%) were rhinoviruses, 59 (26%) were coronaviruses, 22 (9.5%) were influenza A or B, 17 (7%) were respiratory syncytial virus, 7 (3%) were parainfluenza viruses, and 3 (1%) were Chlamydia species; an adenovirus and Mycoplasma pneumoniae caused one infection each. Infections occurred at a rate of 1.2 episodes per person per annum (95% confidence interval 1.0 to 1.7; range 0-10) and were clinically indistinguishable. Lower respiratory tract symptoms complicated 65% of upper respiratory infections and increased the medical consultation rate 2.4-fold (chi 2 test P < 0.001). The median interval between onset of illness and medical consultation was 3 days for influenza and 5 days for other infections. Rhinoviruses caused the greatest disease burden overall followed by episodes of unknown aetiology, coronaviruses, influenza A and B, and respiratory syncytial virus.


CONCLUSIONS
Respiratory viruses cause substantial morbidity in elderly people. Although respiratory syncytial virus and influenza cause considerable individual morbidity, the burden of disease from rhinovirus infections and infections of unknown aetiology seems greater overall. The interval between onset of illness and consultation together with diagnostic difficulties raises concern regarding the role of antiviral drugs in treating influenza.
Nicholson
K G
KG
Leicester University School of Medicine, Department of Microbiology and Immunology.
Kent
J
J
Hammersley
V
V
Cancio
E
E
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017281:Cost of Illness; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D014777:Virus Diseases / Q000150:complications / Q000453:epidemiology*
D000900:Anti-Bacterial Agents