A study of respiratory infections in the elderly to assess the role of respiratory syncytial virus

Morales, Fatima; Calder, Margaret A.; Inglis, J.M.; Murdoch, P S; Williamson, J.

doi:10.1016/s0163-4453(83)97142-6

Cited by 57 publications

(25 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…None of the patients died, but 2 of those infected with RSV developed pneumonia. Morales and co-workers [16] reported 12 RSV infections with 2 deaths among 159 respiratory episodes during a 6-month study of respiratory infections in geriatric wards in Edinburgh, and Sorvillo and colleagues [17] describe an outbreak in a Los Angeles County nursing home in which 40 out of 101 (40%) residents were affected, 22 (55%) of whom had pneumonia and 8 (20%) died. In the current study RSV infections were proven in 9 residents in 3 homes.…”

Section: Discussionmentioning

confidence: 99%

Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly

Nicholson¹,

Baker²,

Farquhar³

et al. 1990

Epidemiol. Infect.

View full text Add to dashboard Cite

SUMMARYOccupants of 482 long-stay and 33 short-stay beds in 11 Leicester City Council homes for the elderly were studied during a 30-week period from September 1988 to March 1989 to determine the incidence, aetiology, morbidity, and mortality of acute upper respiratory tract viral infections and the use of influenza vaccine.Influenza immunization rates by home ranged from 15·4 to 90% (mean 45%). There were no differences in the distribution of medical conditions by home. The highest immunization rates were seen in people with chest disease (77%), heart disease (60%), diabetes (56%), and those with three medical conditions (75%). There was an average of 0·7 upper respiratory episodes per bed per annum with a mortality of 3·4% (6/179). Half of all episodes were seen by a general medical practitioner and 81 of 90 (90%) referrals were prescribed antibiotics costing approximately £7.50 per patient. Lower respiratory tract complications developed during 45 (25%) of 179 episodes including 3 of 12 coronavirus infections, 3 of 9 respiratory syncytial virus infections, 2 of 4 adenovirus infections, 1 of 11 rhinovirus infections, but none of 5 influenza infections. Respiratory infections were caused mostly by pathogens other than influenza virus during the influenza period documented nationally. This highlights the role of coronaviruses, respiratory syncytial virus, and unidentified agents in the elderly, and questions the assumptions made in American estimates on the impact of influenza and the value of influenza vaccines.

show abstract

Section: Discussionmentioning

confidence: 99%

Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly

Nicholson¹,

Baker²,

Farquhar³

et al. 1990

Epidemiol. Infect.

View full text Add to dashboard Cite

show abstract

“…In the elderly RSV can produce a 'flu-like syndrome indistinguishable from influenza and is known to cause a high incidence of pneumonia and death [6][7][8][9][10][11][12][13][14]. The estimates provided by the present analysis indicate that RSV gives rise to considerable mortality in England and Wales causing 60-80% more deaths than influenza, i.e., a predicted 22000-23000 deaths each winter.…”

Section: Primary Regression With Forced Variablesmentioning

confidence: 92%

“…None of the patients died, but 2 of those with RSV infection developed pneumonia. Morales and coworkers [11] reported 12 RSV infections with 2 deaths among 159 respiratory episodes during a 6-month study of respiratory infections in geriatric wards in Edinburgh, and Sorvillo and colleagues [12] describe an outbreak in a Los Angeles County nursing home in which 40 of 101 (40 %) residents were affected, 22 (55 %) of whom had pneumonia and 8 (20%) died.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of influenza and respiratory syncytial virus on mortality in England and Wales from January 1975 to December 1990

1996

View full text Add to dashboard Cite

SUMMARYThe effects of influenza A and B and RSV on mortality in England and Wales were assessed by regression analysis for the period 1975-90. Morbidity data from sentinel practices were used to calculate 4-weekly rates of aggregated upper respiratory tract infections (URTI); PHLS laboratory reports were used as indices of infection, and 4-weekly death rates from all causes, excluding childbirths, were used to study relationships with mortality. Deaths correlated strongly with influenza A and B reports, temperature, and interactions between aggregated URTI and temperature, and RSV outbreaks and temperature. Estimates of 'seasonal' 4-weekly mortality associated with URTI were made by substituting into primary regression models the mean of annual trough consultation rates for aggregated URTI and baseline values for RSV and influenza. Peak 4-weekly mortality associated with URTIs was estimated at c. 24000 and c. 28000 during combined influenza and RSV epidemics of 1975-6 and 1989-90 respectively. Secondary regression analysis was carried out with the estimated 'seasonal' 4-weekly deaths associated with URTI as dependant variable and laboratory data as regressors. Estimated excess mortality associated with influenza was considerable even during years without major epidemics. Overall during the 15 winters the estimated mortality associated with RSV was 60-80% more than that associated with influenza. The modelling permits only a crude estimate of RSV associated mortality. None the less it suggests that RSV is an important cause of winter mortality.

show abstract

“…Clinically severe RSV infections involving the lower respiratory tract are primarily seen in young children with naïve immune systems and/or genetic predispositions (32), patients with suppressed T-cell immunity (such as heart transplant recipients [41]), and the elderly (48). In autopsy studies of fatal disease, RSV infection is characterized by the presence of cytoplasmic eosinophilic inclusion bodies, characteristic of viral replication, in airway epithelial cells; sloughing and necrosis of the epithelial surface; and concomitant mucous plugging of the airways with trapping of air (1,18,19).…”

mentioning

confidence: 99%

Expression of Respiratory Syncytial Virus-Induced Chemokine Gene Networks in Lower Airway Epithelial Cells Revealed by cDNA Microarrays

Zhang¹,

Luxon²,

Casola³

et al. 2001

J Virol

209

223

View full text Add to dashboard Cite

Respiratory syncytial virus (RSV), named by its ability to induce fusion of infected epithelial cells (49), is a leading cause of epidemic respiratory tract illness in children (28). Spread primarily by contact with contaminated secretions, RSV replicates in the nasopharyngeal epithelium and spreads to the lower respiratory tract via epithelial cell-to-cell transfer along intracytoplasmic bridges (27). Although only two RSV serotypes, A and B, circulate in RSV epidemics (29), immunity to naturally acquired infection is incomplete, resulting in repeated infections through adulthood (24; reviewed in reference 28). In humans, RSV infection produces a spectrum of airway involvement ranging from otitis media to lower tract infection.Clinically severe RSV infections involving the lower respiratory tract are primarily seen in young children with naïve immune systems and/or genetic predispositions (32), patients with suppressed T-cell immunity (such as heart transplant recipients [41]), and the elderly (48). In autopsy studies of fatal disease, RSV infection is characterized by the presence of cytoplasmic eosinophilic inclusion bodies, characteristic of viral replication, in airway epithelial cells; sloughing and necrosis of the epithelial surface; and concomitant mucous plugging of the airways with trapping of air (1,18,19). In addition to these manifestations of direct epithelial involvement, RSV infection produces a pronounced perivascular infiltrate of mononuclear cells and lymphocytes (1, 18) and a neutrophil-rich exudate detected by bronchoalveolar lavage (16). Finally, the presence of eosinophil cationic protein (20,30) and histamine (64) in nasal secretions at concentrations that correlate with disease severity suggests the participation of eosinophils and basophils in the pathology of RSV infection.The mechanisms responsible for recruitment of circulating leukocytes, mononuclear cells, and lymphocytes into the lung as a consequence of RSV infection are largely unknown. Cellular recruitment into inflamed tissues is a multistep process in which circulating leukocytes first demarginate, adhere to stimulated endothelial cells, and subsequently become activated. Activated leukocytes then migrate through the vascular endothelium toward chemical gradients of chemoattractant peptides or antigens (reviewed in reference 58). Recent attention has focused on the important role of chemokines in mediat-* Corresponding author. Mailing address: Division of Endocrinology, MRB 8.138, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-1060.

show abstract

A study of respiratory infections in the elderly to assess the role of respiratory syncytial virus

Cited by 57 publications

References 8 publications

Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly

Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly

Impact of influenza and respiratory syncytial virus on mortality in England and Wales from January 1975 to December 1990

Expression of Respiratory Syncytial Virus-Induced Chemokine Gene Networks in Lower Airway Epithelial Cells Revealed by cDNA Microarrays

Contact Info

Product

Resources

About