Two outbreaks of severe respiratory disease in nursing homes associated with rhinovirus

Lauri A. Hicks, Colin W. Shepard, Phyllis H. Britz, Dean D. Erdman, Marc Fischer, Brendan L. Flannery, Angela J. Peck, Xiaoyan Lu, Lanier Thacker, Robert F. Benson, Maria L. Tondella, Mària E. Moll, Cynthia G. Whitney, Larry J. Anderson, Daniel R. Feikin

Research output: Contribution to journalReview articlepeer-review


OBJECTIVES: To characterize illness and identify the etiology for two nursing home outbreaks of respiratory illness. DESIGN: Multisite outbreak investigations; cohort. SETTING: Two nursing homes in Pennsylvania. PARTICIPANTS: Facility A residents (n=170), Facility B residents (n=124), and employees (n=91). MEASUREMENTS: Medical records for Facility A and B residents were reviewed, and employees from Facility B self-administered a questionnaire to identify risk factors for illness. Serological, oropharyngeal, and nasopharyngeal specimens were collected for both outbreaks, and testing for respiratory pathogens was performed. RESULTS: In Facility A, 40 (24%) of 170 residents were identified with respiratory illness; 13 (33%) case-patients had radiographically confirmed pneumonia, 15 (38%) were taken to a hospital, and two (5%) died. Of 10 specimens collected from symptomatic Facility A case-patients, four (40%) tested positive using reverse transcription polymerase chain reaction for rhinovirus. In Facility B, 77 (62%) of 124 residents had respiratory illness, and 40 (52%) had radiographically confirmed pneumonia; 12 (16%) case-patients were hospitalized, and five (6%) died. Of 19 respiratory specimens collected from symptomatic Facility B case-patients, six (32%) were positive for rhinovirus; one was from an employee. Five (50%) of 10 rhinovirus-positive cases in both outbreaks had clinical and radiographic evidence of pneumonia. CONCLUSION: These investigations suggest that rhinoviruses may be an underrecognized cause of respiratory outbreaks in nursing homes, capable of causing pneumonia and perhaps death.

Original languageEnglish (US)
Pages (from-to)284-289
Number of pages6
JournalJournal of the American Geriatrics Society
Issue number2
StatePublished - Feb 2006
Externally publishedYes


  • Aged
  • Disease outbreaks
  • Nursing homes
  • Respiratory tract infections
  • Rhinovirus

ASJC Scopus subject areas

  • Geriatrics and Gerontology


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