Tina G. Wald, MD; Peter Shult, PhD; Peggy Krause, RN; Barbara A. Miller, BSN; Paul Drinka, MD; Stefan Gravenstein, MD
To describe the epidemiology of and clinical findings associated with a rhinovirus outbreak that occurred among institutionalized elderly persons.
Retrospective review of medical records and nursing surveillance reports.
A 685-bed, long-term care facility for veterans and their spouses.
33 persons from whom rhinovirus was cultured.
Throat and nasopharyngeal virus culture; review of medical records to determine underlying diseases, signs and symptoms of respiratory illness, illness duration, and interventions during illness; and review of nursing surveillance reports to determine room locations of ill persons.
Between 14 August and 2 September 1993, the number of respiratory illnesses increased. Throat and nasopharyngeal virus cultures were taken from 67 ill residents; 33 cultures yielded rhinovirus, and no other respiratory virus was isolated. Geographic clustering of persons infected with rhinovirus was observed. Of those persons with rhinovirus infections, 100% had upper respiratory symptoms, 34% had gastrointestinal symptoms, 71% had systemic symptoms, 66% had lower respiratory symptoms (including productive cough), and 52% had new abnormalities on lung auscultation. The 17 persons with rhinovirus infection who had chronic obstructive pulmonary disease had more severe illnesses: Five (29%) required glucocorticoid or bronchodilator therapy for illness-associated bronchospasm; 2 required transfer out of the facility; 1 developed a radiographically documented infiltrate; and 1 died of respiratory failure.
Rhinovirus may cause epidemic, clinically important respiratory illness in nursing home residents. A large proportion of residents may become ill, and infection may be severe in persons with underlying lung disease.
Tina G. Wald, Peter Shult, Peggy Krause, Barbara A. Miller, Paul Drinka, Stefan Gravenstein. A Rhinovirus Outbreak among Residents of a Long-Term Care Facility. Ann Intern Med. 1995;123:588–593. doi: 10.7326/0003-4819-123-8-199510150-00004
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Published: Ann Intern Med. 1995;123(8):588-593.
Geriatric Medicine, Infectious Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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