1. Respiratory syncytial virus outbreak in a long-term care facility detected using reverse transcriptase polymerase chain reaction: an argument for real-time detection methods
- Author
-
Caram, L Brett, Chen, Jodi, Taggart, E William, Hillyard, David R, She, Rosemary, Polage, Christopher R, Twersky, Jack, Schmader, Kenneth, Petti, Cathy A, and Woods, Christopher W
- Subjects
Male ,respiratory syncytial virus ,Respiratory Syncytial Virus Infections ,and over ,Medical and Health Sciences ,long-term care facilities ,Disease Outbreaks ,Risk Factors ,Predictive Value of Tests ,Diagnosis ,80 and over ,North Carolina ,Humans ,Homes for the Aged ,Viral ,Respiratory Tract Infections ,Aged ,Cross Infection ,Reverse Transcriptase Polymerase Chain Reaction ,Pneumonia ,Middle Aged ,Respiratory Syncytial Viruses ,Nursing Homes ,Cross-Sectional Studies ,Geriatrics ,Population Surveillance ,Facility Design and Construction ,Differential ,Female - Abstract
ObjectivesTo report an outbreak of respiratory synctyial virus (RSV) in a long-term care facility (LTCF) during ongoing routine respiratory illness surveillance.DesignRapid antigen testing, viral culture, direct fluorescent antibody (DFA) testing, and reverse transcriptase polymerase chain reaction (RT-PCR) testing for up to 15 viruses in symptomatic residents and chart review.SettingA 120-bed LTCF.MeasurementsComparison of rapid antigen testing, respiratory viral cultures, and DFA testing and RT-PCR in residents with symptoms of a respiratory tract infection.ResultsTwenty-two of 52 residents developed symptoms of a respiratory tract infection between January 29, 2008, and February 26, 2008. RSV was detected using RT-PCR in seven (32%) of the 22 cases. None of the seven cases had positive RSV rapid antigen testing, and only two had positive culture or DFA results. This outbreak occurred during a time when state wide RSV rates were rapidly declining. One patient was admitted to the hospital during the infection and subsequently died.ConclusionRSV may cause outbreaks in LTCFs that traditional diagnostic methods do not detect. RT-PCR can provide a more timely and accurate diagnosis of outbreaks, which allows for early symptomatic treatment, rational use of antibiotics, and improved infection control.
- Published
- 2009