Respiratory Syncytial Virus Disproportionately Impacts Older Adults in Long-Term Care Settings

Strategic Insights -

A retrospective cohort study published in the Journal of the American Medical Directors Association has shed light on the burden of respiratory syncytial virus (RSV) infection in older adults residing in long-term care facilities (LTCFs). The research, conducted by a team of researchers from the University of Rochester Medical Center, aimed to quantify the burden of RSV infection, hospitalization, and in-hospital death in older adults residing in LTCFs compared with those in the community. The study found that RSV infection and complication rates were significantly higher in LTCF residents, with hospitalization rates 6.6 times higher in skilled nursing facility (SNF) residents and 7.2 times higher in assisted living facility (ALF) residents compared with community-dwelling (CD) adults. In-hospital mortality rates were also significantly higher in LTCF residents, with a rate in SNF residents 16.6 times and ALF residents 18.5 times higher than in CD adults.

Key Takeaways:

  • The full burden of RSV infection in the LTCF population is not well defined, and ongoing surveillance is needed to evaluate the effectiveness of interventions and monitor RSV trends in this vulnerable population.
  • The study found that 1660 RSV infections were identified during the surveillance period, with an average infection rate of 4151.9 per 100,000 persons for SNF residents, 1635.0 for ALF residents, and 503.7 for CD older adults.
  • Hospitalization rates were 6.6 times higher in SNF residents and 7.2 times higher in ALF residents compared with CD adults.
  • In-hospital mortality rates were significantly higher in LTCF residents, with a rate in SNF residents 16.6 times and ALF residents 18.5 times higher than in CD adults.
  • Seasonal attack rates in SNFs varied between 0.3% and 28.5%.
  • The study underscores the need for targeted RSV prevention strategies in LTCFs, including routine vaccination and infection detection, to mitigate the impact of RSV.

Statistics:

  • 1660 RSV infections were identified during the surveillance period.
  • The average infection rates were 4151.9 per 100,000 persons for SNF residents, 1635.0 for ALF residents, and 503.7 for CD older adults.
  • Hospitalization rates were 6.6 times higher in SNF residents and 7.2 times higher in ALF residents compared with CD adults.
  • In-hospital mortality rates were significantly higher in LTCF residents, with a rate in SNF residents 16.6 times and ALF residents 18.5 times higher than in CD adults.
  • Seasonal attack rates in SNFs varied between 0.3% and 28.5%.

Sources:

  • Disproportionate Impact of Respiratory Syncytial Virus (RSV) Among Older Adults in Long-Term Care Settings. Journal of the American Medical Directors Association, 2025;26(9):105760.
  • University of Rochester Medical Center, Center for Community Health and Prevention.
  • Journal of the American Medical Directors Association, published by Elsevier Science Inc.