Objectives: The full burden of respiratory syncytial virus (RSV) infection in the long-term care facility (LTCF) population is not well defined. This study 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.
Design: Retrospective cohort study.
Setting and participants: Monroe County, NY, adults aged 65 years and older with positive RSV test results during the 2022-2023 and 2023-2024 RSV seasons.
Methods: Data were collected through population-based surveillance. Residence type was classified as LTCF [skilled nursing facilities (SNFs) or assisted living facilities (ALFs)] or community-dwelling (CD). RSV infection and complication rates were calculated; complication rates in LTCF residents were compared with CD adults. SNF-specific attack rates were generated.
Results: A total of 1660 RSV infections were identified (270 SNF, 68 ALF, 1322 CD) 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 the 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%.
Conclusions and implications: RSV disproportionately impacts LTCF residents in both SNFs and ALFs, with these populations experiencing much higher hospitalization and mortality rates compared with CD older adults. Our findings underscore the need for targeted RSV prevention strategies in LTCFs, including routine vaccination and infection detection, to mitigate the impact of RSV. Ongoing surveillance is needed to evaluate the effectiveness of these interventions and monitor RSV trends in this vulnerable population.
