Long-term care facilities: a cornucopia of viral pathogens

J Am Geriatr Soc. 2008 Jul;56(7):1281-5. doi: 10.1111/j.1532-5415.2008.01775.x. Epub 2008 Jun 28.

Abstract

Objectives: To determine the frequency and types of respiratory viruses circulating in Boston long-term care facilities (LTCFs) during a 3-year period.

Design: Observational.

Setting: Thirty-three Boston-area LTCFs over a 3-year period.

Participants: Residents of long-term care who had previously participated in a trial of vitamin E supplementation and had paired serum samples available for viral analysis.

Measurements: Viral antibody titers to eight respiratory viruses (influenza A and B, respiratory syncytial virus (RSV), parainfluenza virus serotype three (PIV-3), PIV-2, human metapneumovirus (hMPV), and coronaviruses 229E and OC43) were measured using enzyme immunoassay at baseline and 53 weeks. Infection was defined as a more than quadrupling of viral titers. Clinical data on respiratory illnesses were collected throughout the study period.

Results: A total of 617 persons were enrolled in the trial. Of these, 382 (62%) had sera available for viral analysis. A total of 204 viral infections were documented in 157 subjects. Serological responses to all eight viruses were documented, with hMPV (12.8%) and coronavirus 229E (10.5%) being the most common and PIV-2 (2.4%) the least common. The occurrence of bronchitis (P=.007), pneumonia (P=.02), and any lower respiratory tract infection (P=.002) was significantly associated with having a viral diagnosis.

Conclusion: A wide range of respiratory viruses cocirculates in LTCFs and contributes to respiratory illness morbidity in these populations.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibodies, Viral / blood*
  • Boston / epidemiology
  • Female
  • Humans
  • Immunoenzyme Techniques
  • Long-Term Care
  • Male
  • Metapneumovirus / immunology
  • Metapneumovirus / isolation & purification
  • Metapneumovirus / pathogenicity
  • Nursing Homes*
  • Paramyxoviridae Infections / epidemiology
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / virology*
  • Viruses / isolation & purification*
  • Viruses / pathogenicity

Substances

  • Antibodies, Viral