ACUTE RESPIRATORY-TRACT INFECTION IN DAY-CARE-CENTERS FOR OLDER PERSONS

OBJECTIVE: To evaluate the rate of specific pathogens and clinical syn dromes associated with acute respiratory tract infections (ARTI) in fr ail older persons attending daycare. DESIGN: Prospective descriptive s tudy, without intervention. SETTING: Two sites of a senior daycare pro gram providing all-inclusive care for the older persons in Rochester, New York. PARTICIPANTS: Staff members and participants of the daycare. MEASUREMENTS: Demographic, medical, and physical findings were collec ted from older subjects at baseline and while ill with respiratory ill nesses. Nasopharyngeal specimens for viral and Chlamydia culture and s putum for bacterial culture were obtained from subjects when ill. Acut e and convalescent sera were also collected with each illness and exam ined for viral, chlamydial, and mycoplasma infection. MAIN RESULTS: On e hundred sixty-five illnesses were documented in 165 older daycare pa rticipants as well as 113 illnesses among 67 staff members during the 15-month study. The rate of ARTI in the elderly group was 10.8 per 100 person months. The most common etiologies in both the staff and elder ly participants were respiratory syncytial virus (RSV), Influenza A, a nd coronavirus. The etiologies of illnesses in the staff compared with those in elderly group were similar except that bacterial infections were significantly more common among the elderly (7% vs. O, P = 0.05). Multiple pathogens were found to cocirculate within centers, and no c lear outbreak of a predominant organism was noted. Cough and nasal con gestion characterized most illnesses. The elderly experienced signific antly more cough, dyspnea, and sputum production than did the staff. T here were 10 hospitalizations related to respiratory infections and fo ur deaths during the acute illness among the elderly group and none in staff. CONCLUSIONS: Acute respiratory infections are a common occurre nce in both the staff and participants of a senior daycare center and are the cause of substantial morbidity in frail older persons.