Acute viral infections of upper respiratory tract in elderly people living in the community: comparative, prospective, population based study of disease burden

Abstract

Objective: To evaluate the disease burden of upper respiratory infections in elderly people living at home. Design: Prospective surveillance of elderly people. Intervention: None. Setting: Leicestershire, England Subjects: 533 subjects 60 to 90 years of age. Main outcome measures: Pathogens, symptoms, restriction of activity, duration of illness, medical consultations, interval between onset of illness and medical consultation, antibiotic use, admission to hospital, and death. Results: 231 pathogens were identified for 211 (43%) of 497 episodes for which diagnostic specimens were available: 121 (52%) were rhinoviruses, 59 (26%) were coronaviruses, 22 (9.5%) were influenza A or B, 17 (7%) were respiratory syncytial virus, 7 (3%) were parainfluenza viruses, and 3 (1%) were Chlamydia species; an adenovirus and Mycoplasma pneumoniae caused one infection each. Infections occurred at a rate of 1.2 episodes per person per annum (95% confidence interval 1.0 to 1.7; range 0-10) and were clinically indistinguishable. Lower respiratory tract symptoms complicated 65% of upper respiratory infections and increased the medical consultation rate 2.4-fold ( 2 test P < 0.001). The median interval between onset of illness and medical consultation was 3 days for influenza and 5 days for other infections. Rhinoviruses caused the greatest disease burden overall followed by episodes of unknown aetiology, coronaviruses, influenza A and B, and respiratory syncytial virus. Conclusions: Respiratory viruses cause substantial morbidity in elderly people. Although respiratory syncytial virus and influenza cause considerable individual morbidity, the burden of disease from rhinovirus infections and infections of unknown aetiology seems greater overall. The interval between onset of illness and consultation together with diagnostic difficulties raises concern regarding the role of antiviral drugs in treating influenza.

The post‐infection outcomes of influenza and acute respiratory infection in patients above 50 years of age in Japan: an observational study

“…Among the respiratory viruses tested for and identified, influenza was dominant (almost 80·0%), which agrees with previous reports relating to the elderly 2 , 11 . In our study, influenza viruses were four times more prevalent than RSV and 35 times more common than hMPV.…”

Performance of rapid influenza testing in hospitalized children

“…Specifically, the detection of influenza infection presenting with both fever and cough was observed to have sensitivities ranging between 64 and 86%, specificities between 55 and 67%, and PPVs ranging between 48 and 87% [5,6,19,20]. This contrasts other studies which reported that no clinical signs or symptoms are specific for influenza virus infection [21,22]. The present study indicates that the clinical diagnosis of influenza, based on the combined presence of fever and cough, is difficult among children in everyday clinical practice.…”

Fatores associados à vacinação contra influenza em idosos em município do Sudeste do Brasil

“…The most relevant virus types include respiratory syncytial viruses, parainfluenza viruses, rhinoviruses, and adenoviruses, among others. 7,12 Thus, vaccination would not protect the population against any airways infection, but only against cases of influenza infection by viruses that are part of the vaccine used in that season. 2 Regarding specific symptoms, fever was rarely reported by subjects, even in the presence of other more frequent respiratory symptoms such as coughing, nose discharge, and sore throat.…”