Rhinovirus Outbreaks in Long-term Care Facilities, Ontario, Canada

Jean Longtin,Alireza Eshaghi,Alex Marchand-Austin,Jonathan B Gubbay,Frances Jamieson,Donald E Low,Anne-Luise Winter,Samir Patel

doi:10.3201/eid1609.100476

Abstract

Diagnostic difficulties may have led to underestimation of rhinovirus infections in long-term care facilities. Using surveillance data, we found that rhinovirus caused 59% (174/297) of respiratory outbreaks in these facilities during 6 months in 2009. Disease was sometimes severe. Molecular diagnostic testing can differentiate these outbreaks from other infections such as influenza.

Highlights

Diagnostic difficulties may have led to underestimation of rhinovirus infections in long-term care facilities
The Study Using data from an active surveillance network, we investigated all respiratory outbreaks [9], in long-term care facilities, reported from July 1 through December 31, 2009, in the province of Ontario, Canada
To type the human rhinovirus (HRV) implicated in outbreaks during which deaths occurred, we amplified and sequenced the hypervariable region of the 5′ noncoding region, the entire viral capsid protein (VP) 4 gene, and the 5′ terminus of the VP2 gene; we constructed phylogenetic trees as described [10,11]

Summary

Introduction

Diagnostic difficulties may have led to underestimation of rhinovirus infections in long-term care facilities. The Study Using data from an active surveillance network, we investigated all respiratory outbreaks (as defined by the Ministry of Health) [9], in long-term care facilities, reported from July 1 through December 31, 2009, in the province of Ontario, Canada. Multiplex NAT (Luminex xTAG Respiratory Viral Panel; Luminex Diagnostics, Toronto, Ontario, Canada) was used according to the manufacturer’s recommendations to test nasopharyngeal swabs for viral pathogens (adenovirus, influenza A/B, parainfluenzae 1–4, RSV A/B, enterovirus [ENT]/HRV, coronavirus OC43/229E/ NL63/HKU1, and metapneumovirus).

Results

Conclusion