Abstracts from the 5th International Conference on Prevention & Infection Control (ICPIC 2019)

Abstract

Introduction: Nursing home residents live confined, in close contact with one another and staff, increasing opportunities for viral spread. During winter season, Respiratory Syncytial Virus (RSV) might affect the residents as much as influenza virus. However, data estimating RSV morbidity and mortality in nursing homes remain scarce. Objective(s): Describe epidemiology of RSV in nursing homes during influenza season Methods: In influenza seasons 2016-2017 and 2017-2018, a study on the burden of influenza was led in nursing homes of canton de Vaud. Nasal swabs were collected in residents symptomatic with an influenza-like illness. The samples were analyzed with a coupled PCR diagnosing influenza A/B as well as RSV. As a result, the diagnosis of RSV was underlined, even though it was not the purpose of the study.Demographic characteristics of resident were recorded (clinical data, hospitalization, mortality). Result(s): 509 residents with influenza-like illness (ILI) symptoms were included. 38 RSV infected residents (7.5%) were diagnosed in 15 different nursing homes. 10 of these nursing homes experienced an epidemic situation with >=2 residents diagnosed and 2 of them with 5 and 6 simultaneous cases respectively. Median age was 87 years (SD 7). Median temperature at diagnosis was 37.9degreeC (SD 1.1). The three most represented symptoms were cough (89.5%), malaise (73.7%) and fever (71.1%). 12 residents (31.2%) required oxygen therapy and 26 residents (68.4%) were treated with an antibiotic. 3 residents were hospitalized within 30 days after diagnosis (7.9%). 8 residents died within the first 30 days (21%) and a total of 14 residents died within 90 days (37%). Conclusion(s): This study revealed that RSV infections in the institutionalized elderly is an underestimated threat. Residents with a RSV infection encounter a risk for hospitalization and mortality. Although the study was conducted on a relatively small number of residents, it reveals the need to take into account this pathogen in case of influenza-like illness outbreak in nursing home. Moreover, RSV outbreaks can occur in nursing homes. In case of influenza-like illness epidemic in a nursing home, if samples are negative for influenza, RSV should be looked for.