Background
Little is known about the burden of illness associated with respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) in adults, especially young adults.
Methods
We prospectively enrolled Middle Tennessee residents ≥18 years old evaluated in the emergency department (ED) or hospitalized for respiratory symptoms May 2009 through April 2010. We collected samples for RSV and HMPV reverse-transcriptase polymerase chain reaction (RT-PCR) testing and obtained demographic and clinical data. Rates of ED visits and hospitalizations were calculated using the proportion of enrolled patients positive for each virus multiplied by the number of Middle Tennessee residents evaluated in EDs and/or hospitalized in Tennessee for acute respiratory illness during the study period.
Results
3256 patients were eligible; 1477 (45.4%) were enrolled; 1248 (84.5%) of these consented to additional testing and had adequate samples. RT-PCR identified 32 (2.6%) patients with RSV and 33 (2.6%) with HMPV. The median duration of symptoms before ED presentation was 3.3 days with RSV and 2.8 days with HMPV, and before hospital admission was 4.5 days with RSV and 3.5 days with HMPV. The annual hospitalization and ED visit rates were similar for RSV and HMPV. The hospitalization rate associated with each virus was about 10 per 10000 persons aged ≥50 years; ED rates were approximately 2 times higher. Hospitalization rates were about 2 per 10000 persons aged 18–49 years, with ED rates 5 to 6 times higher.
Conclusion
RSV and MPV are associated with substantial disease in adults, with hospitalization and ED visits rates increasing with age.
To determine the number of emergency department visits attributable to influenza A(H1N1)pdm09 in Davidson County, Tennessee, USA, we used active, population-based surveillance and laboratory-confirmed influenza data. We estimated ≈10 visits per 1,000 residents during the pandemic period. This estimate should help emergency departments prepare for future pandemics.
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