Skip to main content
PMC home page
Elsevier - PMC COVID-19 Collection logoLink to Elsevier - PMC COVID-19 Collection
. 2005 Mar 29;16(4):152–158. doi: 10.1016/0196-6553(88)90026-0

Upper respiratory tract infection and serum antibody responses in nursing home patients☆

Julio C Arroyo a,b,∗, Wanda Jordan a,b, Lloyd Milligan a,b
PMCID: PMC7172501  PMID: 2847597

Abstract

Residents of a Veterans Administration nursing home care unit (NHCU) were observed for the development of upper respiratory tract infection (URI) during 12 consecutive months to determine the frequency of sporadic cases of outbreaks of URI and to characterize them clinically and by laboratory means. Fifty-nine episodes of URI occurred in 56 residents during the study period. Serologic testing or virus isolation proved or suggested an etiologic agent on 22 occasions. URI was more common in late Fall and Winter and was caused by various agents, including influenza, Mycoplasma pneumoniae, respiratory syncytial virus, and parainfluenza viruses. A minor outbreak of influenza B in February 1986 contrasted with previous cases of URI in that the patients had a higher mean temperature and abnormal breath sounds, and they were clinically sicker. This suggests that clinical and epidemiologic surveillance during the influenza season may allow the early recognition of influenza in elderly nursing home residents. Over a 4-year period 147 serum antibody responses after influenza infection or influenza vaccination were compiled. Antibody responses to individual influenza vaccine components were measured 75 to 90 days after vaccination. The geometric mean titer (GMT) and the percentage of samples with antibody levels ⩾ 1:40 were determined for each of the three antigenic subtypes on 3 consecutive years. The GMT to individual vaccine components was consistently greater than 1:40, except to influenza B/Singapore in 1984 and A/Chile and B/U.S.S.R. in 1985, when these subtypes were first included in the vaccine, suggesting the NHCU residents responded less vigorously to unfamiliar vaccine subtypes. In 1984 the GMT to A/Phillippines of unvaccinated NHCU residents without URI was surprisingly no different from the corresponding GMT of their vaccinated counterparts, raising the possibility that an influenza A/Phillippines outbreak in 1983 conferred herd immunity.

Footnotes

☆

Supported by the Research and Development Services, Dorn Veterans Administration Hospital.

References

  • 1.Goodman RA, Orenstein WA, Munro TF, Smith SC, Sikes RK. Impact of influenza A in a nursing home. JAMA. 1982;247:1451–1453. [PubMed] [Google Scholar]
  • 2.Centers for Disease Control Outbreaks in influenza among nursing home residents—Connecticut, United States. MMWR. 1985;34:478–482. [PubMed] [Google Scholar]
  • 3.Mathur V, Bentley DW, Hall CB. Concurrent respiratory syncytial virus and influenza A infections in the institutionalized elderly and chronically ill. Ann Intern Med. 1980;93:49–52. doi: 10.7326/0003-4819-93-1-49. [DOI] [PubMed] [Google Scholar]
  • 4.Hall WN, Goodman RA, Noble GR, Kendal AP, Steece RS. An outbreak of influenza B in an elderly population. J Infect Dis. 1981;144:297–302. doi: 10.1093/infdis/144.4.297. [DOI] [PubMed] [Google Scholar]
  • 5.Hoffman PC, Dixon RE. Control of influenza in the hospital. Ann Intern Med. 1977;87:725–728. doi: 10.7326/0003-4819-87-6-725. [DOI] [PubMed] [Google Scholar]
  • 6.Gwaltney JM, Moskalski PB, Hendley JO. Hand-to-hand transmission of rhinovirus colds. Ann Intern Med. 1978;88:463–467. doi: 10.7326/0003-4819-88-4-463. [DOI] [PubMed] [Google Scholar]
  • 7.Schneider EL. Infectious diseases in the elderly. Ann Intern Med. 1983;98:395–400. doi: 10.7326/0003-4819-98-3-395. [DOI] [PubMed] [Google Scholar]
  • 8.Mathur V, Bentley DW, Hall CB, Roth FK, Douglas RG. Influenza A/Brazil/78 (H1N1) infection in the elderly. Am Rev Respir Dis. 1981;123:633–635. doi: 10.1164/arrd.1981.123.6.633. [DOI] [PubMed] [Google Scholar]
  • 9.Howells CH, Vesselinova-Jenkins CK, Evans AD, James J. Influenze vaccination and mortality from broncho-pneumonia in the elderly. Lancet. 1987;1:381–383. doi: 10.1016/s0140-6736(75)91291-x. [DOI] [PubMed] [Google Scholar]
  • 10.Ershler WB, Moore AL, Socinski MA. Influenza and aging: age-related changes and the effects of thymosin on the antibody response to influenza vaccine. J Clin Immunol. 1984;4:445–454. doi: 10.1007/BF00916574. [DOI] [PubMed] [Google Scholar]
  • 11.Downtown JH, Andrews K, Puxty JAH. “Silent” pyrexia in the elderly. Age Ageing. 1987;16:41–44. doi: 10.1093/ageing/16.1.41. [DOI] [PubMed] [Google Scholar]
  • 12.Whittle JL, Bates JE. Thermoregulatory failure secondary to acute illness: complications and treatment. Arch Intern Med. 1979;139:418–421. [PubMed] [Google Scholar]
  • 13.Gleckman R, Hibert D. Afebrile bacteremia: a phenomenon in geriatric patients. JAMA. 1982;248:1478–1481. doi: 10.1001/jama.248.12.1478. [DOI] [PubMed] [Google Scholar]
  • 14.Van Voris LP, Belshe RB, Shaffer JL. Nosocomial influenza B virus infection in the elderly. Ann Intern Med. 1982;96:153–158. doi: 10.7326/0003-4819-96-2-153. [DOI] [PubMed] [Google Scholar]
  • 15.Douglas RG, Bentley DW, Brandriss MW. Responses of elderly and chronically ill subjects to bivalent influenza A/New Jersey/8/76 (Hsw/N1-A/Victoria/3/75 (H3N2) vaccines. J Infect Dis. 1977;136:526–532. doi: 10.1093/infdis/136.supplement_3.s526. (suppl) [DOI] [PubMed] [Google Scholar]
  • 16.Arroyo JC, Postic B, Brown A, Harrison K, Birgenheier R, Dowda H. Influenza A/Philippines/2/82 outbreak in a nursing home: limitations of influenza vaccination in the aged. Am J Infect control. 1984;12:329–334. doi: 10.1016/0196-6553(84)90005-1. [DOI] [PubMed] [Google Scholar]
  • 17.Centers for Disease Control . Influenza—United States, 1985–1986 season. Vol. 35. 1986. pp. 470–479. (MMWR). [Google Scholar]
  • 18.Mufson MA. Coronaviruses. In: Belshe RB, editor. PSG Publishing; Littleton, Mass: 1984. pp. 385–389. (Textbook of human virology). [Google Scholar]
  • 19.Valenti WM. Nosocomial viral infections. In: Belshe RB, editor. PSG Publishing; Littleton, Mass: 1984. pp. 231–266. (Textbook of human virology). [Google Scholar]
  • 20.Smith CB, Golden CA, Kanner RE, Renzetti AD. Association of a viral and Mycoplasma pneumoniae infections with acute respiratory illness in patients with chronic obstructive pulmonary diseases. Am Rev Respir Dis. 1980;121:225–232. doi: 10.1164/arrd.1980.121.2.225. [DOI] [PubMed] [Google Scholar]
  • 21.Gregg MB. The epidemiology of influenza in humans. Ann NY Acad Sci. 1980;353:45–53. doi: 10.1111/j.1749-6632.1980.tb18904.x. [DOI] [PubMed] [Google Scholar]
  • 22.Fox VP, Cooney MK, Hall CE, Foy HM. Influenza virus infections in Seattle families, 1975–1979. II. Pattern of infection in invaded households and relation of age and prior antibody to occurrence of infection and related illness. Am J Epidemiol. 1982;116:228–242. doi: 10.1093/oxfordjournals.aje.a113408. [DOI] [PubMed] [Google Scholar]
  • 23.Subi KK, Lember AE, Tapupere VO. Mixed respiratory viral infections during influenze A epidemics. J Hyg Epidemiol Immunol. 1981;25:270–276. [PubMed] [Google Scholar]
  • 24.Phair J, Kauffman CA, Bjornson A, Adams L, Linneman C. Failure to respond to influenza vaccine in the aged: correlation with B-cell number and function. J Lab Clin Med. 1978;92:822–828. [PubMed] [Google Scholar]
  • 25.Ruben FL. Prevention of influenza in the elderly. J Am Geriatr Soc. 1982;30:577–580. doi: 10.1111/j.1532-5415.1982.tb05666.x. [DOI] [PubMed] [Google Scholar]
  • 26.Potter CW, Oxford JS. Determinants of immunity to influenza infection in man. Br Med Bull. 1979;35:69–75. doi: 10.1093/oxfordjournals.bmb.a071545. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Infection Control are provided here courtesy of Elsevier

RESOURCES