BACKGROUND Data on the true prevalence of respiratory syncytial virus (RSV) among medically attended acute respiratory illnesses (MAARI) has been limited by the lack of regular clinical testing of mild to moderate illnesses. Here we present a prospective evaluation of the epidemiology of RSV-associated MAARI across age groups and multimorbidity status over 3 seasons, which is informative in light of the recommendations for shared decision making for vaccination in older adults. METHODS Ambulatory patients ≥6 months of age meeting a common MAARI case definition were prospectively enrolled in the Michigan Ford Influenza Vaccine Effectiveness (MFIVE) study, a subsite of the US Influenza Vaccine Effectiveness Network. All participants were tested by nasal-throat swab for RSV and influenza, including subtype, independently from clinician-directed testing. Participant illness characteristics and calculated multimorbidity-weighted index (MWI) were collected by in-person survey and electronic medical record review. RESULTS Over 3 surveillance seasons (fall 2017 to spring 2020), 9.9% (n = 441) of 4442 participants had RSV detected. RSV-associated MAARI was more prevalent than influenza for participants 6 months to 4 years of age. Adults with RSV-MAARI had higher median MWI scores overall compared to influenza-MAARI and controls with neither virus (1.62, 0.40, and 0.64, respectively). CONCLUSIONS RSV is a significant, underrecognized cause of MAARI in both children and adults presenting for ambulatory care. Multimorbidity is an important contributor to RSV-associated MAARI in outpatient adults, providing information to support shared clinical decision making for vaccination.

中文翻译：

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三个季节内就医急性呼吸系统疾病的成人和儿童呼吸道合胞病毒的流行病学。


背景 由于缺乏对轻度至中度疾病的定期临床检测，关于就医急性呼吸系统疾病 （MAARI） 中呼吸道合胞病毒 （RSV） 真实患病率的数据受到限制。在这里，我们对 3 个季节跨年龄组的 RSV 相关 MAARI 的流行病学和多病共存状态进行了前瞻性评估，鉴于老年人疫苗接种的共同决策建议，这具有参考价值。方法 前瞻性纳入符合常见 MAARI 病例定义的 6 个月大的门诊≥患者被前瞻性纳入密歇根福特流感疫苗有效性 （MFIVE） 研究，该研究是美国流感疫苗有效性网络的一个子站点。所有参与者都通过鼻咽拭子检测 RSV 和流感，包括亚型，独立于临床医生指导的检测。通过面对面调查和电子病历审查收集参与者疾病特征和计算的多病共患加权指数 （MWI）。结果 在 3 个监测季节（2017 年秋季至 2020 年春季）中，9.9 名参与者中有 4442% （n = 441） 检测到 RSV。对于 6 个月至 4 岁的参与者，RSV 相关 MAARI 比流感更普遍。与流感-MAARI 和两种病毒的对照组相比，患有 RSV-MAARI 的成人的总体中位 MWI 评分更高（分别为 1.62、0.40 和 0.64）。结论 RSV 是儿童和成人门诊护理中 MAARI 的一个重要、未被充分认识的原因。多病共存是门诊成人 RSV 相关 MAARI 的重要因素，为支持疫苗接种的共同临床决策提供信息。