Severe Illnesses Associated With Outbreaks of Respiratory Syncytial Virus and Influenza in Adults

Abstract

Background. Recent reports have described the contribution of adult respiratory syncytial virus (RSV) infections to the use of advanced healthcare resources and death.Methods. Data regarding patients aged ≥18 years admitted to any of Maryland's 50 acute-care hospitals were evaluated over 12 consecutive years (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013). We examined RSV and influenza (flu) surveillance data from the US National Respiratory and Enteric Virus Surveillance System and the Centers for Disease Control and Prevention and used this information to define RSV and flu outbreak periods in the Maryland area. Outbreak periods consisted of consecutive individual weeks during which at least 10% of RSV and/or flu diagnostic tests were positive. We examined relationships of RSV and flu outbreaks to occurrence of 4 advanced medical outcomes (hospitalization, intensive care unit admission, intubated mechanical ventilation, and death) due to medically attended acute respiratory illness (MAARI).Results. Occurrences of all 4 MAARI-related hospital advanced medical outcomes were consistently greater for all adult ages during RSV, flu, and combined RSV-flu outbreak periods compared to nonoutbreak periods and tended to be greatest in adults aged ≥65 years during combined RSV-flu outbreak periods. Rate ratios for all 4 MAARI-related advanced medical outcomes ranged from 1.04 to 1.38 during the RSV, flu, or combined RSV-flu outbreaks compared to the nonoutbreak periods, with all 95% lower confidence limits >1.Conclusions. Both RSV and flu outbreaks were associated with surges in MAARI-related advanced medical outcomes (hospitalization, intensive care unit admission, intubated mechanical ventilation, and death) for adults of all ages.

Determining the seasonality of respiratory syncytial virus in Slovenia

“…It has been estimated recently that RSV causes 33.1 million episodes of RSV‐associated lower respiratory tract infections globally, which results in about 3.2 million hospital admissions, and approximately 60 000 in‐hospital deaths in children younger than 5 years in developing countries 3 . The contribution of adult RSV infections to the utilisation of advanced healthcare resources, morbidity and mortality has become increasingly clear in recent years 4,5 . Respiratory syncytial virus season results in a substantial burden on healthcare services 6,7 .…”

“…3 The contribution of adult RSV infections to the utilisation of advanced healthcare resources, morbidity and mortality has become increasingly clear in recent years. 4,5 Respiratory syncytial virus season results in a substantial burden on healthcare services. 6,7 RSV infections have significant health, financial and social impact in both high-and low-income countries.…”

Clinical Outcome of Viral Respiratory Tract Infections in Hospitalized Adults in Norway: High Degree of Inflammation and Need of Emergency Care for Cases With Respiratory Syncytial Virus

“…While there is a large amount of published literature on viral respiratory tract infections (RTIs) in children, the clinical features and outcomes of such infections in adults have not been studied to the same degree (1,2). Although extensive research has been carried out on influenza infections in adults, fewer studies have investigated other viral RTIs like respiratory syncytial virus (RSV) or human metapneumovirus (hMPV) regarding the extent of their disease burden.…”

“…Recently, diagnostic advances with nucleic acid-based multiplex methods have shown that viral respiratory pathogens can be detected in a high percentage of adult cases in primary care and hospital settings (7). It has become apparent that outbreaks of RSV in the population are associated with increased rates of hospitalization in adults, but the extent of the problem needs to be investigated (2). Little is known about the severity of different viral RTIs in adults and the resulting mortality rates.…”

Hospitalisation, morbidity and outcomes associated with respiratory syncytial virus compared with influenza in adults of all ages

“… 1 , 2 Subsequent ecological data demonstrated that during seasonal influenza and RSV peaks, there were increased hospitalisations and increased rates of morbidity amongst respiratory illness attributed hospitalisations; with this temporal link raising the possibility of a causal association between these occurrences. 3 , 4 , 5 A case control study in 2018 demonstrated that patients older than 60 years of age hospitalised with RSV had a higher prevalence of comorbidities and worse morbidity and mortality outcomes when compared with influenza. 6 The manifestations and implications of RSV in younger adult cohorts have not been characterised in depth.…”