A prospective, community-based study on virologic assessment among elderly people with and without symptoms of acute respiratory infection

Graat, Judith M; Schouten, Evert G; Heijnen, Marie-Louise A; Kok, Frans J; Pallast, Esther G.M; de Greeff, Sabine C; Dorigo-Zetsma, J.Wendelien

BACKGROUND AND OBJECTIVE: Community-based elderly studies concerning microbiology of acute respiratory infections are scarce. Data on subclinical infections are even totally absent, although asymptomatic persons might act as a source of respiratory infections. METHODS: In a 1-year community-based study, we prospectively investigated the possible virologic cause of acute respiratory infections in 107 symptomatic case episodes and 91 symptom-free control periods. Participants, persons ⩾60 years, reported daily the presence of respiratory symptoms in a diary. Virologic assessment was performed by polymerase chain reaction (PCR) and serology. RESULTS: In 58% of the case episodes a pathogen was demonstrated, the most common being rhinoviruses (32%), coronaviruses (17%), and influenzaviruses (7%). The odds ratio for demonstrating a virus in cases with symptoms vs. controls without symptoms was 30.0 (95% confidence interval 10.2–87.6). In 4% of the symptom-free control periods a virus was detected. CONCLUSION: This study supports the importance of rhinovirus infections in community-dwelling elderly persons, whereas asymptomatic elderly persons can also harbor pathogens as detected by PCR, and thus might be a source of infection for their environment.