Two outbreaks of severe respiratory disease in nursing homes associated with rhinovirus.

Abstract:

OBJECTIVES:To characterize illness and identify the etiology for two nursing home outbreaks of respiratory illness. DESIGN:Multisite outbreak investigations; cohort. SETTING:Two nursing homes in Pennsylvania. PARTICIPANTS:Facility A residents (n = 170), Facility B residents (n = 124), and employees (n = 91). MEASUREMENTS:Medical records for Facility A and B residents were reviewed, and employees from Facility B self-administered a questionnaire to identify risk factors for illness. Serological, oropharyngeal, and nasopharyngeal specimens were collected for both outbreaks, and testing for respiratory pathogens was performed. RESULTS:In Facility A, 40 (24%) of 170 residents were identified with respiratory illness; 13 (33%) case-patients had radiographically confirmed pneumonia, 15 (38%) were taken to a hospital, and two (5%) died. Of 10 specimens collected from symptomatic Facility A case-patients, four (40%) tested positive using reverse transcription polymerase chain reaction for rhinovirus. In Facility B, 77 (62%) of 124 residents had respiratory illness, and 40 (52%) had radiographically confirmed pneumonia; 12 (16%) case-patients were hospitalized, and five (6%) died. Of 19 respiratory specimens collected from symptomatic Facility B case-patients, six (32%) were positive for rhinovirus; one was from an employee. Five (50%) of 10 rhinovirus-positive cases in both outbreaks had clinical and radiographic evidence of pneumonia. CONCLUSION:These investigations suggest that rhinoviruses may be an underrecognized cause of respiratory outbreaks in nursing homes, capable of causing pneumonia and perhaps death.

journal_name

J Am Geriatr Soc

authors

Hicks LA,Shepard CW,Britz PH,Erdman DD,Fischer M,Flannery BL,Peck AJ,Lu X,Thacker WL,Benson RF,Tondella ML,Moll ME,Whitney CG,Anderson LJ,Feikin DR

doi

10.1111/j.1532-5415.2005.00529.x

subject

Has Abstract

pub_date

2006-02-01 00:00:00

pages

284-9

issue

2

eissn

0002-8614

issn

1532-5415

pii

JGS529

journal_volume

54

pub_type

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