NEW YORK (Reuters Health) - In elderly adults and patients with cardiopulmonary disease, infection with respiratory syncytial virus (RSV) is an illness on a par with influenza A, according to a report in the April 28th issue of The New England Journal of Medicine.
Previous research has suggested that RSV is a potentially serious problem in older adults, but the extent of illness has not been accurately assessed, lead author Dr. Ann R. Falsey, at the University of Rochester School of Medicine and Dentistry in New York, and her team note.
To investigate, Dr. Falsey’s group followed two prospective cohorts: 608 healthy persons age 65 or older and 540 adults diagnosed with congestive heart failure or chronic pulmonary disease. They also retrospectively evaluated 1388 patients age 65 and older or who had underlying cardiopulmonary disease hospitalized for treatment of acute respiratory symptoms.
RSV infection and influenza A were diagnosed on the basis of culture, reverse-transcriptase polymerase chain reaction, and serologic studies.
During four consecutive winters between 1999 and 2003, RSV was identified in 102 illnesses among patients in the prospective cohorts and in 142 cases involving hospitalized patients. Corresponding numbers for influenza A were 44 and 154. Annual rates of RSV infection were 3% to 7% among healthy elderly subjects and 4% to 10% among those at high risk.
In the prospective cohorts, one quarter of healthy elderly patients and nearly half of high-risk patients sought medical attention for RSV infection. Sixteen percent of those at high risk required hospitalization.
Among hospitalized patients, RSV and influenza A resulted in similar lengths of stay, rates of intensive care use, and mortality (8% in the RSV patients and 7% in influenza patients).
The authors estimate that RSV infection leads to approximately 177,000 hospital admissions per year in the US and 14,000 annual deaths. On the basis of this data, hospitalization costs would exceed $1 billion annually.
These findings “should lead to increased vigilance for this infection on the part of the clinician,” Drs. Sanjay Sethi and Timothy F. Murphy, at the State University of New York in Buffalo, write in a related editorial, although treatment at this point is largely supportive. Perhaps even more important, they say, are efforts to develop an effective RSV vaccine.
Source: N Engl J Med 2005;352:1760-1768. [ Google search on this article ]
MeSH Headings:Behavioral Sciences: Data Collection: Demography: Behavioral Disciplines and Activities: Environment and Public Health: Epidemiologic Methods: Health: Health Occupations: Health Services Administration: Information Science: Longitudinal Studies: Medicine: Investigative Techniques: Mortality: Influenza A Virus, Human: Population Characteristics: Preventive Medicine: Prospective Studies: Public Health: Quality of Health Care: Social Sciences: Specialties, Medical: Vital Statistics: Cohort Studies: Clinical Medicine: Epidemiologic Measurements: Epidemiologic Study Characteristics: Epidemiologic Studies: Polymerase Chain Reaction: Health Care Quality, Access, and Evaluation: Health Care Evaluation Mechanisms: Analytical, Diagnostic and Therapeutic Techniques and Equipment: Anthropology, Education, Sociology and Social Phenomena: Biological Sciences: Health Care: Information Science: Psychiatry and PsychologyCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
