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1、The Common Cold” in Frail Older Persons: Impact of Rhinovirus and Coronavirus in a Senior Daycare Center Ann R. Falsey, MD,* Robert M. McCann, MD,* William. Hall, MD, Mary M. Criddle, RN,“ Maria A. Formica, MS, Dennis Wycofi LPN,John E. Kolassa, PhD+ OBJECTIVE: To evaluate the incidence and impact o
2、f rhino- virus and coronavirus infections in older persons attending daycare. DESIGN: Prospective descriptive study. SETTLNG: Three senior daycare centers in Rochester, New York. PATIENTS: Frail older persons and staff members of the daycare centers who developed signs or symptoms of an acute respir
3、atory illness MEASUREMENTS: Demographic, medical, and physical findings were recorded on subjects at baseline and during respiratory illness. Nasopharyngeal specimens for viral cul- ture as well as acute and convalescent sera for coronavirus 229E enzyme immunoassay (EIA) were obtained for all ill- n
4、esses. RESULTS: During the 44 months of study, 352 older persons experienced 522 illnesses. Thirty-five (7%) of 522 cultures were positive for rhinovirus and 37 (8%) of 451 serologies were positive for coronavirus 229E infection. The clinical syndromes associated with rhinovirus and coronavirus infe
5、c- tion were similar and characterized by nasal congestion, cough, and constitutional symptoms. No patient died or was hospitalized, but approximately 50% had evidence of lower respiratory tract involvement. The average illness lasted 14 days. During the same period, 113 staff developed 338 respi- r
6、atory illnesses. Eight percent were identified as coronavirus and 9% as rhinovirus. Cough, sputum production, and con- stitutional symptoms were significantly more common among older persons. CONCLUSIONS: Rhinovirus and coronavirus 229E are common causes of moderately debilitating acute respiratory
7、illnesses among older persons attending daycare. J Am Geri- atr SOC 45:706-711,1997. Prom the Department of Medicine, The Rochester General Hospital, The Uni- versity of Rochester School of Medicine and Dentistry; and the Departments of tMedicine and tRiostatistics, The University of Rochester Schoo
8、l of Medicine and Dentistry. This work was supported by NIA Grant 1 P60-A6-10463001. Address correspondence to Ann R. Falsey, MD, Infectious Disease Unit, Roches- ter General Hospital, 1425 Portland Ave., Rochester NY 14621. espiratory tract infections are the source of significant R morbidity and m
9、ortality in older persons. Viruses, such as influenza and respiratory syncytial virus (RSV), have been shown to be the cause of serious disease in this age group. Less is known about the impact of rhinoviruses and corona- viruses, the causative agents in the majority of “common colds.” Approximately
10、 20 to 40% of upper respiratory tract infections (URIs) in adults are caused by rhinoviruses, and 5 to 15% are caused by coronaviruses. More than 100 sero- types of rhinoviruses and two major serotypes of coronavirus (229E and OC43) have been idertified.- Reinfections with both viruses occur through
11、out life, in part because of multiple serotypes and incomplete immunity.- While these infec- tions lead to significant time lost from work and school, they generally do not result in serious disease in children or young adults.”I2 Rates of acute respiratory tract infections dimin- ish with advancing
12、 age, most likely as a result of less frequent exposure. However, frail older persons attending adult daycare centers may represent a special population at in- creased risk of infection and at risk for complications from these common infection. The purpose of this study was to evaluate prospectively
13、 the prevalence and clinical features of rhinovirus and coronavirus 229E infections in frail older persons attending senior daycare. METHODS Subjects Volunteers were recruited from three sites of a senior daycare program in Rochester, New York. These facilities allow frail older persons who are nurs
14、ing home-eligible by New York State Medicaid standards to be maintained at home by providing comprehensive medical and social ser- vices. All attendees of the daycare program were recruited to take part in the study. Daycare participants were scheduled to attend the center, on average, 3.5 days per
15、week, with a minimum of once a week. Ill subjects were encouraged to attend the program for evaluation by center physicians. In addition, all staff members with direct contact with older participants were also recruited for the surveillance study. Study Design Informed consent was obtained from volu
16、nteers upon entrance into the daycare program. If volunteers were unable to provide informed consent, consent was obtained from their legal guardians. Baseline information, including medical history and demographics, were obtained from daycare par- ticipants medical records. Subjects were examined at base- _- JAGS 45:706-711,1997 0 1997 by the American Geriatrics Society 0002-8614/97/$3.50 JAGS IUNE 1997-VOL. 4.5, NO. 6 line, and arterial oxygenation saturation (SaO,) was mea
