scholarly journals Antibody and Local Cytokine Response to Respiratory Syncytial Virus Infection in Community-Dwelling Older Adults

mSphere ◽  
2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Xiao Yu ◽  
Anke J. Lakerveld ◽  
Sandra Imholz ◽  
Marion Hendriks ◽  
Sofie C. A. ten Brink ◽  
...  
Keyword(s):  
Older Adults ◽  
Respiratory Syncytial Virus ◽  
Risk Groups ◽  
Community Dwelling ◽  
Severe Morbidity ◽  
Prevention And Treatment ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Community Dwelling Older Adults ◽  
Local Cytokine

ABSTRACT Respiratory syncytial virus (RSV) is increasingly recognized for causing severe morbidity and mortality in older adults, but there are few studies on the RSV-induced immune response in this population. Information on the immunological processes at play during RSV infection in specific risk groups is essential for the rational and targeted design of novel vaccines and therapeutics. Here, we assessed the antibody and local cytokine response to RSV infection in community-dwelling older adults (≥60 years of age). During three winters, serum and nasopharyngeal swab samples were collected from study participants during acute respiratory infection and recovery. RSV IgG enzyme-linked immunosorbent assays (ELISA) and virus neutralization assays were performed on serum samples from RSV-infected individuals (n = 41) and controls (n = 563 and n = 197, respectively). Nasal RSV IgA and cytokine concentrations were determined using multiplex immunoassays in a subset of participants. An in vitro model of differentiated primary bronchial epithelial cells was used to assess RSV-induced cytokine responses over time. A statistically significant increase in serum neutralization titers and IgG concentrations was observed in RSV-infected participants compared to controls. During acute RSV infection, a statistically significant local upregulation of beta interferon (IFN-β), IFN-λ1, IFN-γ, interleukin 1β (IL-1β), tumor necrosis factor alpha (TNF-α), IL-6, IL-10, CXCL8, and CXCL10 was found. IFN-β, IFN-λ1, CXCL8, and CXCL10 were also upregulated in the epithelial model upon RSV infection. In conclusion, this study provides novel insights into the basic immune response to RSV infection in an important and understudied risk population, providing leads for future studies that are essential for the prevention and treatment of severe RSV disease in older adults. IMPORTANCE Respiratory syncytial virus (RSV) can cause severe morbidity and mortality in certain risk groups, especially infants and older adults. Currently no (prophylactic) treatment is available, except for a partially effective yet highly expensive monoclonal antibody. RSV therefore remains a major public health concern. To allow targeted development of novel vaccines and therapeutics, it is of great importance to understand the immunological mechanisms that underlie (protection from) severe disease in specific risk populations. Since most RSV-related studies focus on infants, there are only very limited data available concerning the response to RSV in the elderly population. Therefore, in this study, RSV-induced antibody responses and local cytokine secretion were assessed in community-dwelling older adults. These data provide novel insights that will benefit ongoing efforts to design safe and effective prevention and treatment strategies for RSV in an understudied risk group.

Burden of respiratory syncytial virus infection in community-dwelling older adults in Europe (RESCEU): an international prospective cohort study

2020 ◽  
pp. 2002688
Author(s):  
Koos Korsten ◽  
Niels Adriaenssens ◽  
Samuel Coenen ◽  
Christopher Butler ◽  
Behnaz Ravanfar ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Respiratory Syncytial Virus ◽  
Severe Disease ◽  
Acute Respiratory Tract Infection ◽  
Community Dwelling ◽  
Symptom Duration ◽  
Care Approach ◽  
Syncytial Virus ◽  
Community Dwelling Older Adults

BackgroundRespiratory syncytial virus (RSV) infection in older adults is recognized as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years.MethodsThis international prospective observational cohort study is part of REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited before two independent RSV-seasons through general practitioner's offices. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV-season. . ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV-illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV-ARTI was based on PCR alone (ClinicalTrials.gov, NCT03621930).ResultsWe recruited 1040 participants (527 in season 2017–2018, 513 in season 2018–2019) with a median age of 75 years (range 60–100). 1023 (99%) lived independently at home at baseline. RSV-illness incidence was 4.2% (22/527) and 7.2% (37/513) in the respective seasons. RSV-illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalized or died from RSV-illness. In the 36 patients with PCR confirmed RSV-ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11/36 (31%) of cases. RSV-ARTI could not clinically be differentiated from all other ARTI based on symptoms.ConclusionThis European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care is often justified when RSV is suspected in family practice.

scholarly journals Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment

2016 ◽  
Vol 30 (1) ◽  
pp. 277-319 ◽  
Author(s):  
Cameron Griffiths ◽  
Steven J. Drews ◽  
David J. Marchant
Keyword(s):  
Respiratory Syncytial Virus ◽  
Causes Of Death ◽  
Large Body ◽  
Global Impact ◽  
Airway Diseases ◽  
Prevention And Treatment ◽  
Rsv Infection ◽  
Community Transmission ◽  
Syncytial Virus ◽  
Chronic Sequelae

SUMMARYRespiratory syncytial virus (RSV) infection is a significant cause of hospitalization of children in North America and one of the leading causes of death of infants less than 1 year of age worldwide, second only to malaria. Despite its global impact on human health, there are relatively few therapeutic options available to prevent or treat RSV infection. Paradoxically, there is a very large volume of information that is constantly being refined on RSV replication, the mechanisms of RSV-induced pathology, and community transmission. Compounding the burden of acute RSV infections is the exacerbation of preexisting chronic airway diseases and the chronic sequelae of RSV infection. A mechanistic link is even starting to emerge between asthma and those who suffer severe RSV infection early in childhood. In this article, we discuss developments in the understanding of RSV replication, pathogenesis, diagnostics, and therapeutics. We attempt to reconcile the large body of information on RSV and why after many clinical trials there is still no efficacious RSV vaccine and few therapeutics.

scholarly journals Severe Morbidity and Short- and Mid- to Long-term Mortality in Older Adults Hospitalized with Respiratory Syncytial Virus Infection

2020 ◽  
Vol 222 (8) ◽  
pp. 1298-1310 ◽  
Author(s):  
Hung Fu Tseng ◽  
Lina S Sy ◽  
Bradley Ackerson ◽  
Zendi Solano ◽  
Jeff Slezak ◽  
...  
Keyword(s):  
Older Adults ◽  
Respiratory Syncytial Virus ◽  
Clinical Epidemiology ◽  
Ventilatory Support ◽  
The United States ◽  
Rsv Infection ◽  
Hospitalized Older Adults ◽  
Syncytial Virus ◽  
Long Term Mortality

Abstract Background We describe the clinical epidemiology and outcomes among a large cohort of older adults hospitalized with respiratory syncytial virus (RSV) infection in the United States. Methods Hospitalized adults aged ≥60 years who tested positive for RSV between 1 January 2011 and 30 June 2015 were identified from Kaiser Permanente Southern California. Patient-level demographics, comorbidities, clinical presentation, utilization, complications, and mortality were evaluated. Results There were 664 patients hospitalized with RSV (61% female, 64% aged ≥75 years). Baseline chronic diseases were prevalent (all >30%); 66% developed pneumonia, 80% of which were radiographically confirmed. Very severe tachypnea (≥26 breaths/minute) was common (56%); 21% required ventilator support and 18% were admitted to intensive care unit. Mortality during hospitalization was 5.6% overall (4.6% in 60–74 year olds and 6.1% in ≥75 year olds). Cumulative mortality within 1, 3, 6, and 12 months of admission was 8.6%, 12.3%, 17.2%, and 25.8%, respectively. Conclusion RSV infection in hospitalized older adults often manifested as severe, life-threatening lower respiratory tract illness with high rates of pneumonia, requirement for ventilatory support, and short- and long-term mortality. Increased recognition of the substantial RSV disease burden in adults will be important in evaluation and use of urgently needed interventions.

scholarly journals Severe Morbidity and Mortality Associated With Respiratory Syncytial Virus Versus Influenza Infection in Hospitalized Older Adults

2018 ◽  
Vol 69 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Bradley Ackerson ◽  
Hung Fu Tseng ◽  
Lina S Sy ◽  
Zendi Solano ◽  
Jeff Slezak ◽  
...  
Keyword(s):  
Older Adults ◽  
Respiratory Syncytial Virus ◽  
Disease Burden ◽  
Influenza Infection ◽  
Respiratory Illness ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
Rsv Infection ◽  
Hospitalized Older Adults ◽  
Syncytial Virus

Abstract Background Respiratory syncytial virus (RSV) is an important cause of serious respiratory illness in older adults. Comparison of RSV and influenza infection in hospitalized older adults may increase awareness of adult RSV disease burden. Methods Hospitalized adults aged ≥60 years who tested positive for RSV or influenza between 1 January 2011 and 30 June 2015 were identified from Kaiser Permanente Southern California electronic medical records. Baseline characteristics, comorbidities, utilization, and outcomes were compared. Results The study included 645 RSV- and 1878 influenza-infected hospitalized adults. Patients with RSV were older than those with influenza (mean, 78.5 vs 77.4 years; P = .035) and more likely to have congestive heart failure (35.3% vs 24.5%; P < .001) and chronic obstructive pulmonary disease (COPD) (29.8% vs 24.3%; P = .006) at baseline. In adjusted analyses, RSV infection was associated with greater odds of length of stay ≥7 days (odds ratio [OR] = 1.5; 95% confidence interval [CI], 1.2–1.8; P < .001); pneumonia (OR = 2.7; 95% CI, 2.2–3.2; P < .001); intensive care unit admission (OR = 1.3; 95% CI, 1.0–1.7; P = .023); exacerbation of COPD (OR = 1.7; 95% CI, 1.3–2.4; P = .001); and greater mortality within 1 year of admission (OR = 1.3; 95% CI, 1.0–1.6; P = .019). Conclusions RSV infection may result in greater morbidity and mortality among older hospitalized adults than influenza. Increased recognition of adult RSV disease burden will be important in the evaluation and use of new RSV vaccines and antivirals.

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: diagnosis, prevention and management

2019 ◽  
Vol 6 ◽  
pp. 204993611986579 ◽  
Author(s):  
Rachael Barr ◽  
Christopher A. Green ◽  
Charles J. Sande ◽  
Simon B. Drysdale
Keyword(s):  
United Kingdom ◽  
Respiratory Syncytial Virus ◽  
Severe Disease ◽  
Severe Infection ◽  
Risk Groups ◽  
Control Measures ◽  
Respiratory Morbidity ◽  
The United Kingdom ◽  
Rsv Infection ◽  
Syncytial Virus

Respiratory syncytial virus (RSV) is responsible for a large burden of disease globally and can present as a variety of clinical syndromes in children of all ages. Bronchiolitis in infants under 1 year of age is the most common clinical presentation hospitalizing 24.2 per 1000 infants each year in the United Kingdom. RSV has been shown to account for 22% of all episodes of acute lower respiratory tract infection in children globally. RSV hospitalization, that is, RSV severe disease, has also been associated with subsequent chronic respiratory morbidity. Routine viral testing in all children is not currently recommended by the United Kingdom National Institute for Health and Care Excellence (NICE) or the American Academy of Pediatrics (AAP) guidance and management is largely supportive. There is some evidence for the use of ribavirin in severely immunocompromised children. Emphasis is placed on prevention of RSV infection through infection control measures both in hospital and in the community, and the use of the RSV-specific monoclonal antibody, palivizumab, for certain high-risk groups of infants. New RSV antivirals and vaccines are currently in development. Ongoing work is needed to improve the prevention of RSV infection, not only because of the acute morbidity and mortality, but also to reduce the associated chronic respiratory morbidity after severe infection.

scholarly journals Protein Knowledge of Older Adults and Identification of Subgroups with Poor Knowledge

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1006
Author(s):  
Marjolein Visser ◽  
Yung Hung ◽  
Wim Verbeke
Keyword(s):  
Older Adults ◽  
Knowledge Score ◽  
Risk Groups ◽  
Community Dwelling ◽  
Health Determinants ◽  
Objective Knowledge ◽  
False Statement ◽  
True Statement ◽  
Poor Knowledge ◽  
Community Dwelling Older Adults

The aim was to investigate the protein knowledge of community-dwelling older adults. A survey was conducted among 1825 adults aged ≥65 years and living in Finland, Netherlands, Poland, Spain and United Kingdom in 2017. Protein knowledge was measured with nine objective knowledge statements provided only to participants who indicated to know what the nutrient "protein" is (64.7% of sample). Demographic, socioeconomic and health determinants of poor protein knowledge were investigated using multiple logistic regression analyses. The sample was 49.6% female and 87.0% reported no walking difficulties. Participants scored best on the true statement "You need protein in the diet for repairing bones and muscles" (89.3% correct), and worst on the false statement "One meal per day with a good protein source is sufficient" (25.4% correct). Median knowledge score was 5.0 (scale 0–9) and poor knowledge was present in 49.4% of the sample. Males (Odds Ratio 1.57), those unable to walk for 5 min (2.66), not always making their own food decision (1.36) and having lower income (1.44) were more likely to have poor knowledge. Large differences were observed across countries. In conclusion, poor protein knowledge is present in about half of community-dwelling older adults. Communication strategies should be tailored to target the identified risk groups with poor knowledge.

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%&#x2028;(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.

Severe Clinical Outcomes Among Adults Hospitalized With Respiratory Syncytial Virus Infections, New York City, 2017-2019

2021 ◽  
pp. 003335492110415
Author(s):  
Connor R. Goldman ◽  
William D. Sieling ◽  
Luis R. Alba ◽  
Raul A. Silverio Francisco ◽  
Celibell Y. Vargas ◽  
...  
Keyword(s):  
Older Adults ◽  
New York ◽  
Mechanical Ventilation ◽  
New York City ◽  
Risk Factor ◽  
Respiratory Syncytial Virus ◽  
York City ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Residential Living

Objectives Respiratory syncytial virus (RSV) causes substantial morbidity and mortality in older adults. We assessed severe clinical outcomes among hospitalized adults that were associated with RSV infections. Methods We performed a nested retrospective study in 3 New York City hospitals during 2 respiratory viral seasons, October 2017–April 2018 and October 2018–April 2019, to determine the proportion of patients with laboratory-confirmed RSV infection who experienced severe outcomes defined as intensive care unit (ICU) admission, mechanical ventilation, and/or death. We assessed factors associated with these severe outcomes and explored the effect of RSV-associated hospitalizations on changes in the living situations of surviving patients. Results Of the 403 patients studied (median age, 69 years), 119 (29.5%) were aged ≥80. Severe outcomes occurred in 19.1% of patients, including ICU admissions (16.4%), mechanical ventilation (12.4%), and/or death (6.7%). Patients admitted from residential living facilities had a 4.43 times higher likelihood of severe RSV infection compared with patients who were living in the community with or without assistance from family or home health aides. At discharge, 56 (15.1%) patients required a higher level of care than at admission. Conclusions RSV infection was associated with severe outcomes in adults. Living in a residential facility at admission was a risk factor for severe outcomes and could be a proxy for frailty rather than an independent risk factor. Our data support the development of prevention strategies for RSV infection in older populations, especially older adults living in residential living facilities.

scholarly journals Underlying cardiopulmonary conditions as a risk factor for influenza and respiratory syncytial virus infection among community-dwelling adults aged ≥65 years in Thailand: Findings from a two-year prospective cohort study

2021 ◽  
Author(s):  
Prabda Praphasiri ◽  
Manash Shrestha ◽  
Jayanton Patumanond ◽  
Sutthichai Nakphook ◽  
Sutthinan Chawalchitiporn ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Respiratory Syncytial Virus ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Respiratory Illness ◽  
Community Dwelling ◽  
Chronic Obstructive ◽  
Increased Risk ◽  
Syncytial Virus

Background: Adults with cardiopulmonary conditions are at increased risk for complications from influenza and respiratory syncytial virus (RSV) infection, but few data are available from middle-income countries. Methods: Using data from a prospective cohort study of influenza vaccine effectiveness among community-dwelling Thai adults aged ≥65 years, we estimated and compared the incidence of influenza and RSV in those with and without cardiopulmonary conditions. During May 2015-May 2017, older adults in a rural province in Thailand were followed weekly with year-round surveillance for acute respiratory illness (ARI), defined broadly as new onset or worsening of cough with or without fever, and hospitalized ARI. When ill, nasal self-swabs and/or nasopharyngeal swabs were collected for reverse-transcription polymerase chain reaction testing. We used Poisson regression to calculate incidence rate ratios (IRR), adjusting for age, sex, past healthcare-seeking behavior, weekly influenza activity, and influenza vaccination. Results: Overall, 3,220 adults with a median age of 71 years (IQR 68-76) were enrolled; 1,324 (41.1%) were male; and 313 (9.7%) had ≥1 underlying cardio-pulmonary condition, most commonly chronic obstructive pulmonary disease (131; 41.2%) or asthma (73; 23.3%). Compared to those without, participants with cardiopulmonary conditions had higher incidences of ARI, influenza, and RSV (Adjusted IRR: 1.83, 95% CI 1.63-2.05; 1.84, 95% CI 1.05-3.23; 2.02, 95% CI 1.10-3.72, respectively). Conclusion: Our findings show that older adults in rural Thailand with cardiopulmonary conditions have increased rates of ARI, influenza, and RSV infections, and support efforts to ensure this population has access to influenza vaccines and other respiratory illness prevention measures.

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