An outbreak of respiratory syncytial virus pneumonia in a nursing home for the elderly

Sorvillo, Frank; Huie, Sonja F.; Strassburg, Marc A.; Butsumyo, Aiko; Shandera, Wayne X.; Fannin, Shirley L.

doi:10.1016/s0163-4453(84)90530-9

Cited by 121 publications

(81 citation statements)

References 14 publications

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“…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: 93%

“…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%

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

1996

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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.

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Section: Primary Regression With Forced Variablesmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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

1996

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“…Few residents refused the offer of influenza vaccine and the different immunization rates in the homes reflected the policies of individual medical practitioners. Chronic heart 27(60) 18 Chronic lung 17 Six deaths occurred within 4 weeks of onset of upper respiratory illness. One non-immunized patient died 2 weeks after the appearance of symptoms which occurred during an outbreak of coronavirus OC43 in the home and influenza in the community.…”

Section: Demography and Influenza Immunizationmentioning

confidence: 99%

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

Nicholson¹,

Baker²,

Farquhar³

et al. 1990

Epidemiol. Infect.

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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.

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“…However, since the virus induces poor protective immunity, reinfection throughout life is common. Thus RSV is increasingly recognized as an important cause of otitis media in older children [2] and of serious respiratory disease in the elderly and immunocompromised individuals [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Contribution of RSV to bronchiolitis and pneumonia-associated hospitalizations in English children, April 1995–March 1998

Müller‐Pebody¹,

Edmunds²,

Zambon

et al. 2002

Epidemiol. Infect.

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SUMMARYEstimates of the number of hospitalizations attributable to specific pathogens are required to predict the potential impact of vaccination. All hospital admissions for lower respiratory tract infection (LRI) in children 5 years in England in 1995-8 were reviewed. Most admissions (76n8 %) were not associated with specific organisms. Seasonality in pathogens that cause bronchiolitis and pneumonia was used to predict the proportion of cases with unspecified aetiology attributable to different organisms using multiple linear regression. Of 12 298 admissions for LRI, 17n5 % were due to RSV infection. An estimated 74n8 % (95 % CI, 72n0-77n7 %) of ' unspecified bronchiolitis ' admissions and 16n3 % (95 % CI, 13n7-18n8%) of ' unspecified pneumonia ' admissions were RSV related. The total mean annual incidence of hospital admissions attributable to RSV is 28n3\1000 children 1 year of age, and 1n3\1000 children 1-4 years old. The greater burden of RSV infection than indicated through discharge data is revealed through applying simple statistical methods.

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An outbreak of respiratory syncytial virus pneumonia in a nursing home for the elderly

Cited by 121 publications

References 14 publications

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

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

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

Contribution of RSV to bronchiolitis and pneumonia-associated hospitalizations in English children, April 1995–March 1998

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