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Two Outbreaks of Severe Respiratory Disease in Nursing Homes Associated with Rhinovirus
Author(s) -
Hicks Lauri A.,
Shepard Colin W.,
Britz Phyllis H.,
Erdman Dean D.,
Fischer Marc,
Flannery Brendan L.,
Peck Angela J.,
Lu Xiaoyan,
Thacker W. Lanier,
Benson Robert F.,
Tondella Maria L.,
Moll Mària E.,
Whitney Cynthia G.,
Anderson Larry J.,
Feikin Daniel R.
Publication year - 2006
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2005.00529.x
Subject(s) - medicine , rhinovirus , outbreak , pneumonia , etiology , cohort , respiratory disease , respiratory system , emergency medicine , intensive care medicine , virology , lung
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.