547. Epidemiologic, Clinical, and Virologic Characteristics of Respiratory Syncytial Virus Infection among Otherwise Healthy Adults
Session: Poster Abstract Session: Respiratory Viruses
Thursday, October 8, 2015
Room: Poster Hall
Background:

Respiratory Syncytial Virus (RSV) can cause significant morbidity and mortality among older adults with influenza-like illness (ILI), with most -having underlying co-morbidities.  However, less is known about the clinical characteristics of RSV infection in an otherwise healthy population of adults.

Methods:

We analyzed healthy adults presenting from September 2010 to August 2014 within 72 hours of ILI onset who were prospectively enrolled in an observational cohort study. Viral etiologies were determined by nucleic acid amplification testing of nasopharyngeal specimens.  Demographics, severity markers, and symptom severity were recorded, and subjects completed a daily diary scoring symptom severity. Severity scores were calculated for lower respiratory, GI, composite and systemic symptoms. 

Results: RSV did not account for a large proportion of ILI in our adult population, with variability from year to year noted during the course of the study. Non-Caucasian race (OR 3.29, 95%CI=1.72-6.29) and morbid obesity (BMI 40; OR 17.6, 95%CI=2.33-133.61) were associated with higher rates of RSV infection. In comparison to subjects with rhinovirus and influenza, morbid obesity (8.7%, p=0.01), pregnancy (12.5%, P=0.05), and smoking (26.9%, p=0.01) were found to be significant risk-factors for RSV infection. Severe-moderate nasal congestion, sneezing, and sore throat, were more common in RSV illness (p<0.05) compared with influenza illness, which was more commonly associated with chills, myalgias, and chest discomfort (p<0.05). Overall, composite upper respiratory scores were significantly higher in RSV illness vs. human rhinovirus and influenza illnesses (p<0.01). There were no hospitalizations due to RSV illness in our population. 

Conclusion: This is one of few studies to detail the clinical characteristics of RSV illness in healthy adults presenting with ILI. We found that RSV is an uncommon, but notable cause of ILI in healthy adults. Overall severity of symptoms were generally lower than ILI caused by HRV and influenza, with the exception of more severe upper respiratory symptoms. We also identified novel risk factors for RSV induced ILI: morbid obesity, pregnancy, smoking, and Non-caucasian race.

Anjali Kunz, MD1, Elliott Strube, MD2, Christina Schofield, MD FACP, FIDSA1, Tahaniyat Lalani, MBBS, MHS3, Patrick Danaher, MD, FIDSA4, Michael Rajnik, MD5, Leslie Malone, MS, MB(ASCP)CM6, Elena Grigorenko, PhD7, Donald Stalons, PhD, D(ABMM), MPH6, Deepika Mor, MS8, Michelande Ridore, MS9, Wei-Ju Chen, PhD8, John Arnold, MD10, Eugene Millar, PhD8 and Mary Fairchok, MD11, (1)Madigan Army Medical Center, Tacoma, WA, (2)Pediatrics, Madigan Army Medical Center, Tacoma, WA, (3)Naval Medical Center Portsmouth, Portsmouth, VA, (4)San Antonio Military Health System, Fort Sam Houston, TX, (5)Walter Reed National Military Medical Center, Bethesda, MD, (6)Diatherix Laboratories, Inc., Huntsville, AL, (7)Diatherix Laboratories, Inc, Huntsville, AL, (8)Infectious Disease Clinical Research Program, Uniformed Services University, Bethesda, MD, (9)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD, (10)Naval Medical Center San Diego, San Diego, CA, (11)Pediatrics, Mary Bridge Children's Hospital, Multicare, Tacoma, WA

Disclosures:

A. Kunz, None

E. Strube, None

C. Schofield, None

T. Lalani, None

P. Danaher, None

M. Rajnik, None

L. Malone, Diatherix Lab: Investigator , Salary

E. Grigorenko, Diatherix lab: Investigator , Salary

D. Stalons, Diatherix Lab: Investigator , Salary

D. Mor, None

M. Ridore, None

W. J. Chen, None

J. Arnold, None

E. Millar, None

M. Fairchok, None

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