World Health Organization Influenza-Like Illness Underestimates the Burden of Respiratory Syncytial Virus Infection in Community-Dwelling Older Adults

RESCEU Investigators

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

BACKGROUND: Respiratory syncytial virus (RSV) surveillance is heavily dependent on the influenza-like illness (ILI) case definition from the World Health Organization (WHO). Because ILI includes fever in its syndromic case definition, its ability to accurately identify acute respiratory tract infections (ARTI) caused by RSV in older adults is uncertain. METHODS: The accuracy of the WHO ILI and a modified ILI (requiring only self-reported fever) case definitions in identifying patients with PCR-confirmed RSV-ARTI was evaluated in community-dwelling older adults (≥60 years) from the prospective European RESCEU cohort study. RESULTS: Among 1040 participants, 750 ARTI episodes were analyzed including 36 confirmed RSV-ARTI. Due to a general lack of fever, sensitivity for RSV-ARTI was 33% for modified ILI and 11% for ILI. The area under the curve for both ILI definitions was 0.52 indicating poor discrimination for RSV. RSV-ARTI could not be distinguished from all other ARTI based on clinical symptoms. CONCLUSIONS: The use of ILI underestimated the occurrence of RSV-ARTI in community-dwelling older adults up to 9-fold (11% sensitivity). Because worldwide RSV surveillance depends largely on ILI, there is an urgent need for a better approach to measure the occurrence of RSV disease and the impact of future RSV vaccine introduction. Clinical Trials Registration. NCT03621930.

Original languageEnglish
Pages (from-to)S71-S78
JournalThe Journal of infectious diseases
Volume226
Issue numberSuppl 1
DOIs
Publication statusPublished - 12 Aug 2022
Externally publishedYes

Keywords

  • case definition
  • ILI
  • older adults
  • RESCEU
  • respiratory syncytial virus
  • RSV
  • Prospective Studies
  • World Health Organization
  • Humans
  • Respiratory Syncytial Virus, Human
  • Independent Living
  • Infant
  • Respiratory Syncytial Virus Infections/diagnosis
  • Respiratory Tract Infections
  • Fever
  • Influenza, Human/diagnosis
  • Aged
  • Cohort Studies
  • Virus Diseases

Fingerprint

Dive into the research topics of 'World Health Organization Influenza-Like Illness Underestimates the Burden of Respiratory Syncytial Virus Infection in Community-Dwelling Older Adults'. Together they form a unique fingerprint.

Cite this