Respiratory syncytial virus and other respiratory viral infections in older adults with moderate to severe influenza-like illness.
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.
University of Rochester School of Medicine, Rochester General Hospital, Rochester, New York, United States.
Ann R
AR
Falsey
HSN Volunteer Association Chair in Geriatric Research, Advanced Medical Research Institute of Canada, Sudbury, Ontario, Canada.
Janet E
JE
McElhaney
Vaccination and Travel Medicine Centre, Hradec Kralove, Czech Republic.
Jiri
J
Beran
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Gerrit A
GA
van Essen
Inserm CIC, Hôpital Bichat Claude Bernard National Network of Clinical Investigation in Vaccinology (REIVAC), France.
Xavier
X
Duval
Institut für Tropenmedizin, Tübingen, Germany.
Meral
M
Esen
National Network of Clinical Investigation in Vaccinology (REIVAC), France Inserm CIC, CHRU de Montpellier, Hôpital Saint Eloi, Montpellier, France.
Florence
F
Galtier
Q&T Research Sherbrooke, Sherbrooke, Quebec, Canada.
Pierre
P
Gervais
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan National Yang-Ming University School of Medicine, Taipei, Taiwan.
Shinn-Jang
SJ
Hwang
Institut für Tropenmedizin, Tübingen, Germany.
Peter
P
Kremsner
National Network of Clinical Investigation in Vaccinology (REIVAC), France Inserm, CIC BT505 Université Paris Descartes, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Paris Centre, CIC de Vaccinologie Cochin/Pasteur, Paris, France.
Odile
O
Launay
Centre for Vaccinology, Ghent University and University Hospital, Ghent, Belgium.
Geert
G
Leroux-Roels
Canadian Center for Vaccinology and Capital Health, Dalhousie University Health Sciences Centre, Halifax, Nova Scotia, Canada.
Shelly A
SA
McNeil
Family Medicine Centre, Lubartów, Poland Department of Gynaecology and Oncologic Gynaecology, Military Institute of Medicine, Warsaw, Poland.
Andrzej
A
Nowakowski
GGD Rotterdam-Rijnmond, Rotterdam, The Netherlands.
Jan Hendrik
JH
Richardus
Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México City, México.
Guillermo
G
Ruiz-Palacios
GlaxoSmithKline Vaccines, Wavre, Belgium.
Suzanne
S
St Rose
GlaxoSmithKline Vaccines, Rixensart, Belgium.
Jeanne-Marie
JM
Devaster
GlaxoSmithKline Vaccines, Wavre, Belgium.
Lidia
L
Oostvogels
GlaxoSmithKline Vaccines, Wavre, Belgium.
Serge
S
Durviaux
GlaxoSmithKline Vaccines, Wavre, Belgium.
Sylvia
S
Taylor
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D017326:Clinical Trials, Phase III as Topic; D005260:Female; D006760:Hospitalization; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use; D007251:Influenza, Human / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D011795:Surveys and Questionnaires
D007252:Influenza Vaccines
elderly; epidemiology; influenza; polymerase chain reaction; prevalence; respiratory infection; respiratory syncytial virus