key: cord-0033391-581ecgyd
authors: Checovich, Mary M.; Barlow, Shari; Shult, Peter; Reisdorf, Erik; Temte, Jonathan L.
title: Surveillance of Respiratory Viruses in Long Term Care Facilities
date: 2019-05-30
journal: Online J Public Health Inform
DOI: 10.5210/ojphi.v11i1.9893
sha: 7cb4dbaaf750939aa4e1013d511799fcf5e81d7f
doc_id: 33391
cord_uid: 581ecgyd

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Although residents of LTCFs have high morbidity and mortality associated with ARIs, there is very limited information on the virology of ARI in LTCFs [1, 2] . Moreover, most virological testing of LCTF residents is reactive and is triggered by a resident meeting selected surveillance criteria. We report on incidental findings from a prospective trial of introducing rapid influenza diagnostic testing (RIDT) in ten Wisconsin LTCFs over a two-year period with an approach of testing any resident with ARI.

Any resident with new onset of respiratory symptoms consistent with ARI had a nasal swab specimen collected for RIDT by nursing staff. 

Totals of 164 and 190 specimens were submitted during 2016-2017 and 2017-2018, respectively. RPP identified viruses in 56.2% of specimens, with no difference in capture rate between years (55.5% vs. 56.8%). Influenza A (21.5%), influenza B (16.5%), RSV (19.0%) and hMPV (16.5%) accounted for 73.5% of all detections, while coronaviruses (15.5%), rhino/enteroviruses (8.5%) and parainfluenza (2.5%) were less common. Specific distribution of viruses varied significantly across the two years (Table: X 2 =48.1, df=6; p<0.001).

Surveillance in LTCFs using nasal swabs collected for RIDT is highly feasible and yields virus identification rates similar to those obtained in clinical surveillance of ARI with collection of nasopharyngeal specimens by clinicians and those obtained in a schoolbased surveillance project of ARI with collection of combined nasal and oropharyngeal specimens collected by trained research assistants. Significant differences in virus composition occurred across the two study years. RSV varied little between years while hMPV demonstrated wide variation. Simple approaches to surveillance may provide a more comprehensive assessment of respiratory viruses in LTCF settings. 

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Funding provided by the Wisconsin Partnership Program / Partnership Education and Research Committee. In-kind support was provided by Quidel Corporation. We appreciate contributions from our LTCF study sites.