RISK-FACTORS FOR LOWER RESPIRATORY COMPLICATIONS OF RHINOVIRUS INFECTIONS IN ELDERLY PEOPLE LIVING IN THE COMMUNITY - PROSPECTIVE COHORT STUDY

Objective-To assess the role of rhinoviruses in elderly people living in the community. Design-Prospective community based surveillance of e lderly people, without intervention. Subjects were telephoned weekly t o identify symptomatic upper respiratory tract infections. Symptoms an d impact of illnesses were monitored, and specimens were collected for diagnostic serology and human rhinovirus polymerase chain reaction. S etting-Leicestershire, England. Subjects-533 subjects aged 60 to 90. M ain outcome measures-Symptoms, restriction of activity, medical consul tations, and antibiotic use during 96 rhinovirus infections. Adjusted odds ratios for lower respiratory syndromes with respect to smoking an d health status. Results-A viral cause was established in 211 (43%) of 497 respiratory illnesses; rhinoviruses were identified in 121 (24%) and as single pathogens in 107. The median duration of the first or on ly rhinovirus infection in the 96 people with 107 rhinovirus infection s was 16 days; 18 of the 96 patients were confined to bed and 25 were unable to cope with routine household activities. Overall, 60 patients with rhinovirus infections had lower respiratory tract syndromes; 41 patients consulted their doctor, 31 of them (76%) receiving antibiotic s. One patient died. Logistic regression analysis showed that chronic medical conditions increased the estimated probability of lower respir atory rhinovirus illness by 40% (95% confidence interval 17% to 68%) a nd smoking by 47% (14% to 90%). There were almost six times as many sy mptomatic rhinovirus infections as influenza A and B infections. Concl usions-Rhinoviruses are an important cause of debility and lower respi ratory illness among elderly people in the community. Chronic ill heal th and smoking increase the likelihood of lower respiratory complicati ons from such infections. The overall burden of rhinovirus infections in elderly people may approach that of influenza.