• Ann R Falsey, Janet E McElhaney, Jiri Beran, Gerrit A van Essen, Xavier Duval, Meral Esen, Florence Galtier, Pierre Gervais, Shinn-Jang Hwang, Peter Kremsner, Odile Launay, Geert Leroux-Roels, Shelly A McNeil, Andrzej Nowakowski, Jan Hendrik Richardus, Guillermo Ruiz-Palacios, Suzanne St Rose, Jeanne-Marie Devaster, Lidia Oostvogels, Serge Durviaux, and Sylvia Taylor.
• University of Rochester School of Medicine, Rochester General Hospital, Rochester, New York, United States.
• J. Infect. Dis. 2014 Jun 15; 209 (12): 1873-81.

BackgroundFew 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).MethodsMultiplex 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.ResultsRespiratory 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%).ConclusionsThis 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.© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

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