Respiratory syncytial virus infection in elderly adults

被引:163
作者
Falsey, AR
Walsh, EE
机构
[1] Rochester Gen Hosp, Dept Med, Rochester, NY 14621 USA
[2] Univ Rochester, Sch Med, Dept Med, Rochester, NY USA
关键词
D O I
10.2165/00002512-200522070-00004
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Respiratory syncytial virus (RSV) infection is now recognised as a significant problem in elderly adults. Epidemiological evidence indicates the impact of RSV in older adults may be similar to nonpandemic influenza, both in the community and in long-term care facilities. Attack rates in nursing homes are approximately 5-10% per year with significant rates of pneumonia (10-20%) and death (2-5%). Estimates using US healthcare databases and viral surveillance results over a 9-year period indicate that RSV infection causes approximately 10 000 all-cause deaths annually among persons >64 years of age. In contrast, influenza A accounted for approximately 37 000 yearly deaths in the same age group. The clinical features of RSV infection may be difficult to distinguish from those of influenza but include nasal congestion, cough, wheezing and low-grade fever. Older persons with underlying heart and lung disease and immunocompromised patients are at highest risk for RSV infection-related pneumonia and death. Diagnosis of RSV infection in adults is difficult because viral culture and antigen detection are insensitive, presumably because of low viral titres. The combination of serology and reverse transcriptase polymerase chain reaction assay offers the best sensitivity and specificity for the diagnosis of RSV but unfortunately these techniques are not widely available; consequently, most adult RSV disease goes unrecognised. Although treatment of RSV infection in the elderly is largely supportive, early therapy with ribavirin and intravenous gamma-globulin improves survival in immunocompromised persons. An effective RSV vaccine has not yet been developed. Therefore, prevention of RSV is limited to standard infection control practices, such as hand washing and the use of gowns and gloves.
引用
收藏
页码:577 / 587
页数:11
相关论文
共 120 条
[1]   AN EPIDEMIC OF RESPIRATORY SYNCYTIAL VIRUS IN ELDERLY PEOPLE - CLINICAL AND SEROLOGICAL FINDINGS [J].
AGIUS, G ;
DINDINAUD, G ;
BIGGAR, RJ ;
PEYRE, R ;
VAILLANT, V ;
RANGER, S ;
POUPET, JY ;
CISSE, MF ;
CASTETS, M .
JOURNAL OF MEDICAL VIROLOGY, 1990, 30 (02) :117-127
[2]   ANTIGENIC CHARACTERIZATION OF RESPIRATORY SYNCYTIAL VIRUS-STRAINS WITH MONOCLONAL-ANTIBODIES [J].
ANDERSON, LJ ;
HIERHOLZER, JC ;
TSOU, C ;
HENDRY, RM ;
FERNIE, BF ;
STONE, Y ;
MCINTOSH, K .
JOURNAL OF INFECTIOUS DISEASES, 1985, 151 (04) :626-633
[3]   UPPER RESPIRATORY-TRACT INFECTION AND SERUM ANTIBODY-RESPONSES IN NURSING-HOME PATIENTS [J].
ARROYO, JC ;
JORDAN, W ;
MILLIGAN, L .
AMERICAN JOURNAL OF INFECTION CONTROL, 1988, 16 (04) :152-158
[4]   Evaluation of a quantitative real-time PCR for the detection of respiratory syncytial virus in pulmonary diseases [J].
Borg, I ;
Rohde, G ;
Löseke, S ;
Bittscheidt, J ;
Schultze-Werninghaus, G ;
Stephan, V ;
Bufe, A .
EUROPEAN RESPIRATORY JOURNAL, 2003, 21 (06) :944-951
[5]   NOSOCOMIAL RESPIRATORY SYNCYTIAL VIRUS-INFECTIONS [J].
BREESE, C ;
DOUGLAS, RG ;
GEIMAN, JM ;
MESSNER, MK .
NEW ENGLAND JOURNAL OF MEDICINE, 1975, 293 (26) :1343-1346
[6]   INFECTIONS WITH VIRUSES AND MYCOPLASMA-PNEUMONIAE DURING EXACERBATIONS OF CHRONIC-BRONCHITIS [J].
BUSCHO, RO ;
SAXTAN, D ;
SHULTZ, PS ;
FINCH, E ;
MUFSON, MA .
JOURNAL OF INFECTIOUS DISEASES, 1978, 137 (04) :377-383
[7]   VIROLOGIC STUDY OF CHRONIC BRONCHITIS [J].
CARILLI, AD ;
GOHD, RS ;
GORDON, W .
NEW ENGLAND JOURNAL OF MEDICINE, 1964, 270 (03) :123-&
[8]   Lack of sensitivity of rapid antigen tests for the diagnosis of respiratory syncytial virus infection in adults [J].
Casiano-Colón, AE ;
Hulbert, BB ;
Mayer, TK ;
Walsh, EE ;
Falsey, AR .
JOURNAL OF CLINICAL VIROLOGY, 2003, 28 (02) :169-174
[9]  
*CDC, 1977, MMWR-MORBID MORTAL W, V26, P351
[10]   Orally active fusion inhibitor of respiratory syncytial virus [J].
Cianci, C ;
Yu, KL ;
Combrink, K ;
Sin, N ;
Pearce, B ;
Wang, A ;
Civiello, R ;
Voss, S ;
Luo, GX ;
Kadow, K ;
Genovesi, EV ;
Venables, B ;
Gulgeze, H ;
Trehan, A ;
James, J ;
Lamb, L ;
Medina, I ;
Roach, J ;
Yang, Z ;
Zadjura, L ;
Colonno, R ;
Clark, J ;
Meanwell, N ;
Krystal, M .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2004, 48 (02) :413-422