Abstract
BackgroundAcquired infections in hospitalized elderly people are a growing concern. In long-term care facilities with multiple staff and visitor contacts, virus outbreaks are a common challenge for infection prevention teams. Although several studies have reported nosocomial RSV outbreaks in long term care facilities, molecular epidemiology data are scarce.MethodsRSV RNA was detected in respiratory samples from 19 patients in a long-term care hospital for elderly in Paris in March 2019 over a 3 weeks period. Genotyping was performed using nucleotide sequencing. Sociodemographic and clinical characteristics of cases part of a unique cluster, were retrospectively reviewed.ResultsMolecular investigation of theses RSV cases, revealed a unique cluster of 12 nosocomial cases in 2 adjacent wards. Mean age of these outbreak’s cases was 89. All patients had underlying medical conditions. Seven exhibited lower respiratory symptoms and three experienced decompensation of underlying chronic heart condition. Two patients died.ConclusionsThis case report highlights the importance of RSV in causing substantial disease in elderly in case of nosocomial outbreak and the contributions of molecular epidemiology in investigation and management of such outbreak.
Highlights
Acquired infections in hospitalized elderly people are a growing concern
People are especially vulnerable to infections, including respiratory infections
Nineteen Respiratory Syncytial Virus (RSV) cases were detected in SaintePerine-Chardon-Lagache-Rossini hospital (SPR-CLR) geriatric hospital group over a 20-day period in March 2019
Summary
In long-term care facilities with multiple staff and visitor contacts, virus outbreaks are a common challenge for infection prevention teams. Several studies have reported nosocomial RSV outbreaks in long term care facilities, molecular epidemiology data are scarce. More than 85% of all deaths from lower respiratory tract infections occur in adults over 70 years in high income countries [2]. Contributing factors for increased susceptibility to infection and poor health outcomes include immunosenescence, age related decay of physiological functions and high frequency of comorbid conditions. A large population study in UK reported that 64.9% of adults between 65 and years old and more than 80% of adults over years old exhibited at least two chronic conditions [5]. The number of long-term care facilities for the elderly (LTCF) have increased in modern countries. For instance in France, 10% of people over 70 years old and one third of people over 90 years old are living LCFT in France [6]
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