Influenza– and Respiratory Syncytial Virus–Associated Morbidity and Mortality in the Nursing Home Population

Ellis, Shelly; Coffey, Christopher S.; Mitchel, Edward F.; Dittus, Robert S.; Griffin, Marie R.

doi:10.1046/j.1365-2389.2003.51254.x

Cited by 106 publications

(87 citation statements)

References 36 publications

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“…In our cohort, the incidence of 13% is on the lower limit of the range [5,23,24]. We could not find any correlation between virus species and bacterial infections as has been suggested by other studies [2,6,15,18,19]. …”

Section: Discussionsupporting

confidence: 55%

“…Lower respiratory tract infection (LRTI) is the most frequent cause of hospitalization worldwide [1,2,3,4,5,6,7]. Over the past decade, several studies aimed to define parameters that allow the distinction between bacterial and viral infections causing LRTI.…”

Section: Introductionmentioning

confidence: 99%

“…Bacterial infection is documented in approximately 25% of LRTI patients; however, the majority of LRTI patients are treated with antibiotics [5,23,24]. Despite therapy with antibiotics, the mortality and morbidity associated with LRTI is relevant and might be due to colonization with nonbacterial or antibiotic-resistant microorganisms [2,6]. LRTI caused by nonbacterial infection cannot be treated by antibiotic therapy, and for this condition, the use of antibiotics is known to lead to the occurrence of antibiotic resistance in clinically relevant bacteria [25].…”

Section: Introductionmentioning

confidence: 99%

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Single and Multiple Viral Infections in Lower Respiratory Tract Infection

Gencay¹,

Roth²,

Müeller

et al. 2010

Respiration

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Background: Lower respiratory tract infection (LRTI) often leads to hospitalization, and it was indicated that causative viral infections are underestimated. Objectives: It was our aim to compare the frequency of 8 relevant viruses in 109 hospitalized LRTI patients and 144 healthy controls. Methods: Virus infection was determined by seroconversion and ELISA for anti-virus antibodies in repeated serum samples. Bacterial infection was diagnosed in respiratory specimens, blood cultures and urine. Results: The LRTI patient cohort consisted of 49 patients with community-acquired pneumonia, 30 patients with acute bronchitis and 30 chronic obstructive pulmonary disease patients with acute exacerbation. Viral infection was detected in 89 (82%) LRTI patients compared with 32 (22%) in healthy controls (relative risk 3.42, 95% confidence interval 2.48–4.72; p < 0.0001). The most frequent viral pathogens were: influenza B (23%), adenovirus (16%) and parainfluenza virus 3 (12%). Importantly, infections with more than 1 virus were detected in 63% (n = 57) of LRTI patients with viral infection, which represents 52% of all LRTI patients. No multiple virus infection was detected in the healthy controls. Patients with community-acquired pneumonia were more often infected with adenovirus and respiratory syncytial virus as compared with the other LRTI patients (p = 0.046 and 0.0009, respectively). Conclusions: There is a high incidence of single and multiple viral infections in LRTI patients requiring hospitalization. The data indicate the need for regular virus diagnosis and the development of point of care tools that enables a fast diagnosis of the most common viruses and bacteria. The data also imply the need to consider antiviral therapy in positive LRTI cases.

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Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Single and Multiple Viral Infections in Lower Respiratory Tract Infection

Gencay¹,

Roth²,

Müeller

et al. 2010

Respiration

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“…Influenza outbreaks in nursing homes are associated with increased morbidity, hospitalization and mortality among residents (Ellis et al, 2003). Influenza vaccination effectively reduces the incidence of influenza-like illness (ILI) and associated complications (Jefferson et al, 2005), but outbreaks continue to occur with a high burden of disease (Coles et al, 1992;Hayward et al, 2006;Iorio et al, 2006;Monto et al, 2004;van der Sande et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Rapid molecular detection of influenza outbreaks in nursing homes

Gooskens

Swaan²,

Claas

et al. 2008

Journal of Clinical Virology

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“…[1][2][3] RSV and HMPV circulate like seasonal influenza viruses and can cause comparable hospitalization rates. [4][5][6] Despite the substantial disease morbidity among the older adult population, these infections are still an underrecognized problem likely due to insensitive methods of detection prior to the availability of sensitive molecular testing. 7 These infections also impact older adults living in long-term care or congregate settings.…”

mentioning

confidence: 99%

Paramyxovirus Outbreak in a Long-Term Care Facility: The Challenges of Implementing Infection Control Practices in a Congregate Setting

Spires

Talbot

Pope

et al. 2017

Infect. Control Hosp. Epidemiol.

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objective. We report an outbreak of respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) infections in a dementia care ward containing 2 separately locked units (A and B) to heighten awareness of these pathogens in the older adult population and highlight some of the infection prevention challenges faced during a noninfluenza respiratory viral outbreak in a congregate setting.methods. Cases were defined by the presence of new signs or symptoms that included (1) a single oral temperature ≥ 37.8°C (100.0°F) and (2) the presence of at least 2 of the following symptoms: cough, dyspnea, rhinorrhea, hoarseness, congestion, fatigue, and malaise. Attempted infection-control measures included cohorting patients and staff, empiric isolation precautions, and cessation of group activities. Available nasopharyngeal swab specimens were sent to the Tennessee Department of Health for identification by rT-PCR testing.results. We identified 30 of the 41 (73%) residents as cases over this 16-day outbreak. Due to high numbers of sick personnel, we were unable to cohort staff to 1 unit. Unit B developed its first case 8 days after infection control measures were implemented. Of the 14 cases with available specimens, 6 patients tested positive for RSV-B, 7 for HMPV and 1 patient test positive for influenza A. Overall, 15 cases (50%) required transfer to acute care facilities; 10 of these patients (34%) had chest x-ray confirmed pulmonary infiltrates; and 5 residents (17%) died.conclusions. This case report highlights the importance of RSV and HMPV in causing substantial disease in the older adult population and highlights the challenges in preventing transmission of these viruses.

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Influenza– and Respiratory Syncytial Virus–Associated Morbidity and Mortality in the Nursing Home Population

Cited by 106 publications

References 36 publications

Single and Multiple Viral Infections in Lower Respiratory Tract Infection

Single and Multiple Viral Infections in Lower Respiratory Tract Infection

Rapid molecular detection of influenza outbreaks in nursing homes

Paramyxovirus Outbreak in a Long-Term Care Facility: The Challenges of Implementing Infection Control Practices in a Congregate Setting

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