Long-term care facilities: a cornucopia of viral pathogens.
OBJECTIVE
To determine the frequency and types of respiratory viruses circulating in Boston long-term care facilities (LTCFs) during a 3-year period.


METHODS
Observational.


METHODS
Thirty-three Boston-area LTCFs over a 3-year period.


METHODS
Residents of long-term care who had previously participated in a trial of vitamin E supplementation and had paired serum samples available for viral analysis.


METHODS
Viral antibody titers to eight respiratory viruses (influenza A and B, respiratory syncytial virus (RSV), parainfluenza virus serotype three (PIV-3), PIV-2, human metapneumovirus (hMPV), and coronaviruses 229E and OC43) were measured using enzyme immunoassay at baseline and 53 weeks. Infection was defined as a more than quadrupling of viral titers. Clinical data on respiratory illnesses were collected throughout the study period.


RESULTS
A total of 617 persons were enrolled in the trial. Of these, 382 (62%) had sera available for viral analysis. A total of 204 viral infections were documented in 157 subjects. Serological responses to all eight viruses were documented, with hMPV (12.8%) and coronavirus 229E (10.5%) being the most common and PIV-2 (2.4%) the least common. The occurrence of bronchitis (P=.007), pneumonia (P=.02), and any lower respiratory tract infection (P=.002) was significantly associated with having a viral diagnosis.


CONCLUSIONS
A wide range of respiratory viruses cocirculates in LTCFs and contributes to respiratory illness morbidity in these populations.
Falsey
Ann R
AR
Department of Medicine, Rochester General Hospital, Rochester, New York 14621, USA. ann.falsey@viahealth.org
Dallal
Gerard E
GE
Formica
Maria A
MA
Andolina
Gloria G
GG
Hamer
Davidson H
DH
Leka
Lynette L
LL
Meydani
Simin Nikbin
SN
D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood*; D001900:Boston / Q000453:epidemiology; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008134:Long-Term Care; D008297:Male; D029121:Metapneumovirus / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity; D009735:Nursing Homes; D018184:Paramyxoviridae Infections / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000821:virology*; D014780:Viruses / Q000302:isolation & purification* / Q000472:pathogenicity
D000914:Antibodies, Viral