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Respiratory Syncytial Virus Outbreak in a Long‐Term Care Facility Detected Using Reverse Transcriptase Polymerase Chain Reaction: An Argument for Real‐Time Detection Methods
Author(s) -
Caram L. Brett,
Chen Jodi,
Taggart E. William,
Hillyard David R.,
She Rosemary,
Polage Christopher R.,
Twersky Jack,
Schmader Kenneth,
Petti Cathy A.,
Woods Christopher W.
Publication year - 2009
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.1532-5415.2008.02153.x
Subject(s) - medicine , outbreak , virology , respiratory system , infection control , polymerase chain reaction , reverse transcriptase , respiratory tract , respiratory tract infections , virus , viral culture , lower respiratory tract infection , real time polymerase chain reaction , direct fluorescent antibody , antigen , immunology , intensive care medicine , biology , biochemistry , gene
OBJECTIVES: To report an outbreak of respiratory synctyial virus (RSV) in a long‐term care facility (LTCF) during ongoing routine respiratory illness surveillance. DESIGN: Rapid antigen testing, viral culture, direct fluorescent antibody (DFA) testing, and reverse transcriptase polymerase chain reaction (RT‐PCR) testing for up to 15 viruses in symptomatic residents and chart review. SETTING: A 120‐bed LTCF. MEASUREMENTS: Comparison of rapid antigen testing, respiratory viral cultures, and DFA testing and RT‐PCR in residents with symptoms of a respiratory tract infection. RESULTS: Twenty‐two of 52 residents developed symptoms of a respiratory tract infection between January 29, 2008, and February 26, 2008. RSV was detected using RT‐PCR in seven (32%) of the 22 cases. None of the seven cases had positive RSV rapid antigen testing, and only two had positive culture or DFA results. This outbreak occurred during a time when state wide RSV rates were rapidly declining. One patient was admitted to the hospital during the infection and subsequently died. CONCLUSION: RSV may cause outbreaks in LTCFs that traditional diagnostic methods do not detect. RT‐PCR can provide a more timely and accurate diagnosis of outbreaks, which allows for early symptomatic treatment, rational use of antibiotics, and improved infection control.