scholarly journals Morbidity, and Short- and Intermediate-term Mortality, in Adults ≥60 Years Hospitalized with Respiratory Syncytial Virus Infection vs. Seasonal Influenza Virus Infection

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S318-S319
Author(s):  
Hung Fu Tseng ◽  
Lina S Sy ◽  
Bradley Ackerson ◽  
Christine Fischetti ◽  
Jeff Slezak ◽  
...  
Keyword(s):  
Older Adults ◽  
Respiratory Syncytial Virus ◽  
Mortality Rate ◽  
Virus Infection ◽  
Influenza A ◽  
Seasonal Influenza ◽  
Grant Recipient ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Research Grant

Abstract Background There is increasing evidence that respiratory syncytial virus (RSV) infection can cause serious health problems among older adults, whether healthy and community-dwelling, or high-risk. In older adults, RSV infection can lead to complications that are similar to those resulting from seasonal influenza infection. The aim of this study was to compare the morbidity and mortality in older adults ≥60 years hospitalized with RSV disease vs. those hospitalized with seasonal influenza. Methods This cohort study included members of Kaiser Permanente Southern California aged ≥ 60 years who tested positive for RSV or influenza A/B by multiplex RT-PCR in clinical diagnostic testing during January 1, 2011 to June 30, 2015 and were hospitalized. For multiple eligible hospitalizations, only the first RSV hospitalization for the RSV cohort or first influenza A/B hospitalization for the influenza cohort was included. Electronic medical records for each hospitalized individual were used to extract necessary information, including baseline characteristics, symptoms, comorbidities, and outcomes. Results The study included 664 RSV (mean age 78.5 years, 39.5% male) and 1922 influenza A/B (mean age 77.5 years, 49.7% male) hospitalizations. There were 310 (46.7%) RSV patients and 501 (26.1%) influenza patients with a diagnosis of pneumonia. There were 119 RSV patients (17.9%) vs. 272 (14.2%) influenza patients that were admitted to the intensive care unit during hospitalization (mean stay 6.8 vs. 7.8 days). The short-term mortality rate during hospitalization and within 90 days of discharge was 5.6% (n = 37) and 7.4% (n = 49) in the RSV cohort vs. 4.4% (n = 85) and 6.7%
(n = 129) in the influenza cohort. The intermediate-term mortality rate within 91–180 days of discharge was significantly different between the RSV and the influenza cohorts (4.4% vs. 2.5%). Conclusion RSV infection can lead to complications and severe outcomes that are similar to those of seasonal influenza in older adults. Effective prevention and treatment strategies such as vaccination and antivirals against RSV could potentially reduce the burden of RSV infection as well as complications from disease. Disclosures H. F. Tseng, Novavax: Grant Investigator, Research grant. L. S. Sy, Novavax: Collaborator, Research grant. C. Fischetti, Novavax: Collaborator, Research grant. J. Slezak, Novavax: Collaborator, Grant recipient. Y. Luo, Novavax: Collaborator, Grant recipient. Z. Solano, Novavax Inc.: Collaborator, My employer received research funds to conduct the study. S. Chen, Novavax: Collaborator, Research grant. V. Shinde, Novavax Inc.: Collaborator, My employer received research funds to conduct the study.

scholarly journals 733. Incidence and Evaluation of the Change in Functional Status Associated with Respiratory Syncytial Virus Infection in Hospitalized Older Adults

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S263-S263
Author(s):  
Angela Branche ◽  
Evelyn Granieri ◽  
Edward Walsh ◽  
Lynn Finelli ◽  
William Greendyke ◽  
...  
Keyword(s):  
Older Adults ◽  
Respiratory Syncytial Virus ◽  
Functional Status ◽  
Functional Assessment ◽  
Loss Of Function ◽  
Catchment Areas ◽  
Grant Recipient ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Research Grant

Abstract Background Respiratory Syncytial Virus (RSV) causes severe respiratory illnesses in infants and older adults. Mortality disproportionately affects the elderly, can exacerbate chronic cardiopulmonary conditions and may result in loss of function. The purpose of this study was to determine the incidence of RSV infection in hospitalized adults and evaluate functional changes associated with RSV hospitalization in older adults ≥60 years. Methods Adults ≥18 years of age admitted with an acute respiratory infection (ARI) or exacerbation of chronic cardiopulmonary disease (e.g. CHF, COPD, asthma) preceded by an ARI within 14 days were screened. Subjects were included if hospitalized for ≥24 hours with laboratory confirmed RSV and residing in two catchment areas (Rochester, NY and New York, NY). Illness history, comorbidities and demographic characteristics were collected at enrollment. Enrolled subjects ≥60 years underwent functional status evaluation retrospectively 2 weeks prior to hospitalization, at enrollment, discharge and 2 months using the Lawton–Brody Instrumental Activity of Daily Living (IADL) Scale (0–8), Barthel (ADL) Index (0–100), MRC Breathlessness score (1–5) and Mini-Cog instrument. Results From October 2017 to March 2018, 2,883 adults hospitalized with ARI were tested and 322 (11%) positive for RSV. Seventy-two adults ≥60 years underwent functional assessment. Mean age was 75 years, 53% were female and 58% demonstrated impaired cognition on admission. Five subjects died during hospitalization and one prior to 2-month follow-up. Interim analysis of 2-month functional assessment was available for 39 subjects. RSV illness resulted in acute functional loss in almost all patients. Although there were no statistically significant differences between mean pre-hospitalization and 2-month functional scores, IADL (6.7 vs. 6.0, P = 0.27), ADL (90.4 vs. 88.5, P = 0.67) and MRC (2.96 vs. 2.7, P = 0.57), 23% of subjects required a higher level of care at discharge. Additionally, RSV hospitalization resulted in decreased ADL scores in 36% of subjects and worsening respiratory function in 18% assessed at 2 months (figure). Conclusion Older adults hospitalized with RSV infection demonstrate acute functional decline which may result in prolonged loss of function in some patients. Disclosures A. Branche, Merck: Investigator, Grant recipient and Research grant. E. Granieri, Merck: Investigator, Research grant. E. Walsh, Merck: Investigator, Research grant. L. Finelli, Merck: Employee, Salary. A. R. Falsey, sanofi pasteur: Consultant and Grant Investigator, Consulting fee and Research grant. Gilead: Consultant, Consulting fee. Merck Sharpe and Dome: Investigator, Grant recipient. Janssen Pharmacueticals: Investigator, Grant recipient. Pfizer: Consultant, Research grant. Novavax: Consultant, none. A. Barrett, Merck: Investigator, Research support. L. Saiman, Merck: Investigator, Research grant.

scholarly journals Respiratory syncytial virus infection enhancesPseudomonas aeruginosabiofilm growth through dysregulation of nutritional immunity

2016 ◽  
Vol 113 (6) ◽  
pp. 1642-1647 ◽  
Author(s):  
Matthew R. Hendricks ◽  
Lauren P. Lashua ◽  
Douglas K. Fischer ◽  
Becca A. Flitter ◽  
Katherine M. Eichinger ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Virus Infection ◽  
Airway Epithelium ◽  
Biofilm Formation ◽  
Respiratory Virus ◽  
Bacterial Biofilm ◽  
Nutritional Immunity ◽  
Rsv Infection ◽  
Respiratory Virus Infection ◽  
Syncytial Virus

Clinical observations link respiratory virus infection andPseudomonas aeruginosacolonization in chronic lung disease, including cystic fibrosis (CF) and chronic obstructive pulmonary disease. The development ofP.aeruginosainto highly antibiotic-resistant biofilm communities promotes airway colonization and accounts for disease progression in patients. Although clinical studies show a strong correlation between CF patients’ acquisition of chronicP.aeruginosainfections and respiratory virus infection, little is known about the mechanism by which chronicP.aeruginosainfections are initiated in the host. Using a coculture model to study the formation of bacterial biofilm formation associated with the airway epithelium, we show that respiratory viral infections and the induction of antiviral interferons promote robust secondaryP.aeruginosabiofilm formation. We report that the induction of antiviral IFN signaling in response to respiratory syncytial virus (RSV) infection induces bacterial biofilm formation through a mechanism of dysregulated iron homeostasis of the airway epithelium. Moreover, increased apical release of the host iron-binding protein transferrin during RSV infection promotesP.aeruginosabiofilm development in vitro and in vivo. Thus, nutritional immunity pathways that are disrupted during respiratory viral infection create an environment that favors secondary bacterial infection and may provide previously unidentified targets to combat bacterial biofilm formation.

scholarly journals Absence of nosocomial influenza and respiratory syncytial virus infection in the coronavirus disease 2019 (COVID-19) era: Implication of universal masking in hospitals

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Shuk-Ching Wong ◽  
Germaine Kit-Ming Lam ◽  
Christine Ho-Yan AuYeung ◽  
Veronica Wing-Man Chan ◽  
Newton Lau-Dan Wong ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Virus Infection ◽  
Respiratory Syncytial Virus Infection ◽  
Healthcare Workers ◽  
Influenza A ◽  
Influenza B ◽  
Syncytial Virus

Abstract Universal masking for healthcare workers and patients in hospitals was adopted to combat coronavirus disease 2019 (COVID-19), with compliance rates of 100% and 75.9%, respectively. Zero rates of nosocomial influenza A, influenza B, and respiratory syncytial virus infection were achieved from February to April 2020, which was significantly lower than the corresponding months in 2017–2019.

ACUTE CHEST SYNDROME with RESPIRATORY Syncytial VIRUS and SEASONAL INFLUENZA In CHILDREN with SICKLE CELL DISEASE

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4845-4845
Author(s):  
John J. Strouse ◽  
Sara C Sadreameli ◽  
James F. Casella
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Respiratory Syncytial Virus ◽  
Seasonal Influenza ◽  
Influenza Infection ◽  
Johns Hopkins Hospital ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Rsv Infection ◽  
Syncytial Virus

Abstract Abstract 4845 Background: Respiratory syncytial virus (RSV) has been recognized as a cause of acute chest syndrome (ACS) in children with sickle cell disease (SCD). However, the proportion of children with RSV and SCD that are admitted to hospital or develop ACS is unknown. In studies of young children without SCD, RSV has traditionally been associated with more hospitalizations in the first three years of life then influenza has. To compare the relative severity of RSV vs. seasonal influenza in children with SCD, we compared the clinical characteristics and complications associated with these infections at a single tertiary care hospital. Methods: We defined a case as laboratory-confirmed RSV infection in a patient <18 years with SCD who was evaluated at Johns Hopkins Hospital from 1 September 1993 to June 30 2008. Through July 2006, we searched the discharge and billing databases for Johns Hopkins Hospital to identify those with SCD and laboratory testing for respiratory infections. Thereafter, we prospectively identified cases through divisional records. We confirmed the diagnosis of RSV by review of microbiology results in each patient's paper and/or electronic medical record. We used Fisher's exact test to compare proportions, Student's t-test or Wilcoxon rank-sum test to compare continuous variables, and logistic regression to evaluate associations. Results: We identified 47 patients with SCD and RSV and 76 with influenza during the study period. Clinical symptoms, such as reported fever (83% vs. 89%), cough (98% vs. 93%), and rhinorrhea (90% vs. 80%), were similar for RSV and influenza as were complications, including acute chest syndrome (Table). Treatments given for RSV and influenza including antibacterials (100% vs. 97%), transfusions (7% vs. 11%), and invasive ventilation (4% vs. 0%, p=0.15),with possibly more bronchodilator use for RSV (50% vs. 33%, p=0.055). In a multivariable logistic regression model, older age (OR 1.3 per year, 95% CI 1.04 –1.5, P=.02) and increased white blood cell count (WBC) at presentation (OR 1.2 per 1000/ul increase, 95% CI 1.03 – 1.4, P=0.02) were independently associated with increased risk of ACS in children with RSV. Discussion: Laboratory confirmed RSV infection was predominantly identified in infants and toddlers, while influenza infection was identified in children of all ages. This parallels RSV hospitalizations in the general population, where children are most likely to be hospitalized in the first few years of life. Both older age and high WBC at presentation may be a risk factor for more severe disease. This is unlikely to reflect referral bias (with only the sickest older children being referred for tertiary pediatric care) as a similar pattern was not seen for influenza infection. We conclude that RSV infection is often associated with ACS and similar in severity to influenza infection in children with SCD. An episode of ACS in the first three years of life was associated with more frequent ACS episodes later in childhood in the Dallas Newborn cohort. Since a significant proportion of patients with RSV develop ACS at a young age, RSV infection may represent a modifiable risk factor for recurrent ACS. An area for further study would be the efficacy or cost effectiveness of prevention of RSV-related hospitalizations. Palivizumab, a monoclonal antibody to RSV, has been shown to prevent complications related to RSV in other high risk groups and could be considered as an intervention in SCD that may decrease morbidity. Disclosures: No relevant conflicts of interest to declare.

Differences in respiratory syncytial virus and influenza infection in a house-dust-mite-induced asthma mouse model: consequences for steroid sensitivity

2013 ◽  
Vol 125 (12) ◽  
pp. 565-574 ◽  
Author(s):  
Hiroki Mori ◽  
Nicole S. Parker ◽  
Deborah Rodrigues ◽  
Kathryn Hulland ◽  
Deborah Chappell ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Virus Infection ◽  
Mouse Model ◽  
Influenza Infection ◽  
Prednisolone Treatment ◽  
Dust Mite ◽  
Rsv Infection ◽  
Ifn Γ ◽  
Syncytial Virus ◽  
Clinical Asthma

A significant number of clinical asthma exacerbations are triggered by viral infection. We aimed to characterize the effect of virus infection in an HDM (house dust mite) mouse model of asthma and assess the effect of oral corticosteroids. HDM alone significantly increased eosinophils, lymphocytes, neutrophils, macrophages and a number of cytokines in BAL (bronchoalveolar lavage), all of which were sensitive to treatment with prednisolone (with the exception of neutrophils). Virus infection also induced cell infiltration and cytokines. RSV (respiratory syncytial virus) infection in HDM-treated animals further increased all cell types in BAL (except eosinophils, which declined), but induced no further increase in HDM-elicited cytokines. However, while HDM-elicited TNF-α (tumour necrosis factor-α), IFN-γ (interferon-γ), IL (interleukin)-2, IL-5 and IL-10 were sensitive to prednisolone treatment, concomitant infection with RSV blocked the sensitivity towards steroid. In contrast, influenza infection in HDM- challenged animals resulted in increased BAL lymphocytes, neutrophils, IFN-γ, IL-1β, IL-4, IL-5, IL-10 and IL-12, but all were attenuated by prednisolone treatment. HDM also increased eNO (exhaled NO), which was further increased by concomitant virus infection. This increase was only partially attenuated by prednisolone. RSV infection alone increased BAL mucin. However, BAL mucin was increased in HDM animals with virus infection. Chronic HDM challenge in mice elicits a broad inflammatory response that shares many characteristics with clinical asthma. Concomitant influenza or RSV infection elicits differing inflammatory profiles that differ in their sensitivity towards steroids. This model may be suitable for the assessment of novel pharmacological interventions for asthmatic exacerbation.

scholarly journals Transmission of Respiratory Syncytial Virus Infection Within Families

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Terho Heikkinen ◽  
Heikki Valkonen ◽  
Matti Waris ◽  
Olli Ruuskanen
Keyword(s):  
Respiratory Syncytial Virus ◽  
Virus Infection ◽  
Respiratory Symptoms ◽  
Family Members ◽  
Primary Case ◽  
The Family ◽  
Nasal Swabs ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
A Prospective Study

Abstract Background.  Because the production of an effective respiratory syncytial virus (RSV) vaccine for infants is challenging, vaccination of other family members is one viable alternative to prevent severe RSV illnesses in infants. Methods.  In a prospective study, we enrolled all family members of children who were hospitalized with RSV infection. Nasal swabs for RSV detection were obtained from all participating family members. Data on respiratory symptoms in the family members prior to and after the child's admission were collected using standardized questionnaires. Results.  At the time of or within 1 week after the index child's hospitalization, RSV was detected in 40 (77%) of the 52 families and in 60 (47%) of 129 family members. Forty-nine (82%) of RSV detections in the family members were associated with respiratory symptoms. A sibling or a parent was the probable primary case of RSV in 30 (58%) families. Respiratory syncytial virus loads in the nasal swabs were significantly higher (107.7) in index children than in their parents (105.1, P &lt; .0001). Conclusions.  In most cases, the likely source of an infant's RSV infection is an older sibling or a parent. These findings support the strategy of reducing the burden of RSV in infants by vaccination of their family members.

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