Respiratory Syncytial Virus and Other Respiratory Viral Infections in Older Adults With Moderate to Severe Influenza-like Illness

Ann Falsey (1) , Janet Mcelhaney , Jiri Beran , Gerrit van Essen (2) , Xavier Duval (3, 4) , Meral Esen , Florence Galtier (5, 6) , Pierre Gervais , Shinn-Jang Hwang , Peter Kremsner (7) , Odile Launay (8, 9) , Geert Leroux-Roels (10) , Shelly Mcneil , Andrzej F. Nowakowski (11) , Jan Hendrik Richardus (12) , Guillermo Ruiz-Palacios (13) , Suzanne St Rose (14) , Jeanne-Marie Devaster (15) , Lidia Oostvogels (14) , Serge Durviaux (14) , Sylvia Taylor (14)

1 URMC - University of Rochester Medical Center
2 University Medical Center [Utrecht]
3 CIC epidémiologie clinique/ essais cliniques, Hôpital Bichat - Claude Bernard
4 REIVAC - REseau national d'Investigation clinique en VACcinologie
5 BC2M - Biocommunication en Cardio-Métabolique
6 CIC Montpellier
7 University of Tübingen
8 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
9 CIC 1417 - CIC Cochin Pasteur
10 Center for Vaccinology
11 Department of Mechanical Engineering [Sheffield]
12 Department of Public Health
13 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán - National Institute of Medical Science and Nutrition Salvador Zubiran [Mexico]
14 GlaxoSmithKline Vaccines [Wavre]
15 GlaxoSmithKline Vaccines [Rixensart, Belgium]

Background. Few studies have prospectively assessed viral etiologies of acute respiratory infections in community-based elderly individuals. We assessed viral respiratory pathogens in individuals ≥65 years with influenza-like illness (ILI). Methods. Multiplex reverse-transcriptase polymerase chain reaction identified viral pathogens in nasal/throat swabs from 556 episodes of moderate-to-severe ILI, defined as ILI with pneumonia, hospitalization, or maximum daily influenza symptom severity score (ISS) >2. Cases were selected from a randomized trial of an adjuvanted vs nonadjuvanted influenza vaccine conducted in elderly adults from 15 countries. Results. Respiratory syncytial virus (RSV) was detected in 7.4% (41/556) moderate-to-severe ILI episodes in elderly adults. Most (39/41) were single infections. There was a significant association between country and RSV detection (P = .004). RSV prevalence was 7.1% (2/28) in ILI with pneumonia, 12.5% (8/64) in ILI with hospitalization, and 6.7% (32/480) in ILI with maximum ISS > 2. Any virus was detected in 320/556 (57.6%) ILI episodes: influenza A (104/556, 18.7%), rhinovirus/enterovirus (82/556, 14.7%), coronavirus and human metapneumovirus (each 32/556, 5.6%). Conclusions. This first global study providing data on RSV disease in ≥65 year-olds confirms that RSV is an important respiratory pathogen in the elderly. Preventative measures such as vaccination could decrease severe respiratory illnesses and complications in the elderly.

Mots clés: respiratory infection; elderly; respiratory syncytial virus; influenza; epidemiology; prevalence; polymerase chain reaction

Domaines: Maladies infectieuses; Pneumologie et système respiratoire; Gériatrie et gérontologie; Santé publique et épidémiologie

Ann Falsey, Janet Mcelhaney, Jiri Beran, Gerrit van Essen, Xavier Duval, et al.. Respiratory Syncytial Virus and Other Respiratory Viral Infections in Older Adults With Moderate to Severe Influenza-like Illness. Journal of Infectious Diseases, 2014, 209 (12), pp.1873-1881. ⟨10.1093/infdis/jit839⟩. ⟨hal-02098367⟩