1277. Can Analysis of Routine Viral Testing Provide Accurate Estimates of Respiratory Syncytial Virus (RSV) Disease Burden in Adults?
Session: Poster Abstract Session: Clinical Infectious Diseases: Respiratory Infections
Friday, October 28, 2016
Room: Poster Hall
  • Final ID Week Poster- Edited.pdf (582.5 kB)
  • Background: RSV is increasingly recognized as a significant cause of respiratory illness in adults. Promising vaccines and antiviral agents are in development with adult populations considered potential target groups. However, additional epidemiological data are desirable to fully define disease burden. Many clinical laboratories now use multiplex molecular tests for influenza diagnosis, often identifying RSV as a consequence. We evaluated the utility of routinely collected viral test results and discharge diagnoses for identifying the burden of RSV and influenza in winter.

    Methods: Results of the Simplexa ® Influenza/RSV Polymerase Chain Reaction (PCR) assay ordered for routine rapid diagnosis of viral infection in adults seen in the emergency room (ER) or admitted to Rochester General Hospital (Monroe County, NY) from October 2015- April 2016 were reviewed. Data were compared with rates of influenza like illness (ILI) ER visits and influenza activity in the county. Charts of adults testing positive for influenza or RSV were reviewed for discharge diagnoses (ICD-10).

    Results: Of 3956 PCR assays 536 were positive; RSV 133 (30 ER, 103 hospitalized) and influenza 406 (216 ER, 188 hospitalized). Peak RSV activity preceded peak influenza activity by 10 weeks. Of hospitalized RSV cases, only 5 (5%) listed RSV as the primary discharge diagnosis, 51 (50%) in any discharge diagnosis while 52 (50.5%) failed to mention RSV. Notation of influenza in discharge diagnoses was significantly more common: 56 (30%) listed influenza as the primary diagnosis, 149 (79%) noted influenza in any discharge diagnosis and 39 (21%) had no mention of influenza (p<0.005 for all comparisons). To assess viral testing bias we calculated ratios of viral tests ordered to ER ILI activity in Monroe County during the 4 week periods of peak RSV and influenza activity. Notably, viral testing increased by 30% during peak influenza activity compared to the 4 weeks of peak RSV activity.

    Conclusion: Our data suggest that routine viral testing to estimate RSV disease burden in adults may be useful but with limitations, especially testing bias. Mining ICD-10 databases for RSV related illness is problematic, even when RSV testing is positive, due to under reporting of RSV as a diagnosis on discharge forms.

    Siddhant Datta, MD, Internal Medicine, Rochester General Hospital, Rochester, NY, Edward Walsh, MD, FIDSA, Infectious Diseases, Rochester General Hospital, Rochester, NY and Ann R. Falsey, MD, Medicine, Division of Infectious Diseases, University of Rochester School of Medicine and Dentistry, Rochester, NY


    S. Datta, None

    E. Walsh, None

    A. R. Falsey, None

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