학술논문

Influenza-like illness surveillance may underestimate the incidence of respiratory syncytial virus in adult outpatients
Document Type
article
Source
International Journal of Infectious Diseases, Vol 141, Iss , Pp 106968- (2024)
Subject
Respiratory syncytial virus
Rsv
Influenza-like illness
Acute respiratory infection
Case definition
Adults
Infectious and parasitic diseases
RC109-216
Language
English
ISSN
1201-9712
Abstract
ABSTRACT: Objectives: Although respiratory syncytial virus (RSV) is a leading cause of acute respiratory infections (ARIs), it is unclear which of the case definitions that prompt swab collection predicts RSV best. We aimed to profile RSV-positive adults and to identify possible RSV case definitions. Methods: This individual-based pooled analysis was based on influenza-like illness (ILI) surveillance conducted among Italian outpatient adults. All samples were tested for influenza, RSV and other respiratory viruses. Results: RSV was detected in 5.2% of the 1240 ILI adults tested. The prevalence of fever/feverishness was significantly lower (83.3%) in individuals positive for RSV and those negative for both viruses (79.4%) than in influenza-positive subjects (96.2%). Conversely, 98.3% of RSV-positive adults reported cough. Compared with subjects who tested negative, the adjusted relative risk ratio of cough in RSV-positive subjects was much higher than in influenza-positive subjects (6.89 vs 2.79). Using ARI with cough as the RSV case definition increased specificity. Conclusion: As fever/feverishness is more common among influenza than RSV cases, ILI-based surveillance may underestimate RSV incidence in adult outpatients. While broad ARI definitions are useful for routine RSV surveillance, their low specificity may hamper vaccine effectiveness studies. The use of further ARI qualifiers like cough increases specificity.