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.
Wald TG, Shult P, Krause P, Miller BA, Drinka P, Gravenstein S. A Rhinovirus Outbreak among Residents of a Long-Term Care Facility. Ann Intern Med. ;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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