RSV accounts for a significant proportion of lower respiratory tract infections in children and adults. Older age and comorbidities increase susceptibility to severe forms. The risk of hospitalization is higher in people living in long-term care facilities for older adults (LTCFs). To analyze an RSV outbreak in an LTCF during the COVID-19 pandemic. Retrospective analysis of a respiratory viral outbreak in an LTCF in Vitória, detected through case monitoring by the municipality’s epidemiological surveillance. Samples were collected up to the 7th day of symptoms and analyzed by RT-qPCR to detect COVID-19; in symptomatic individuals who tested negative, influenza and RSV were also tested by RT-qPCR. The municipal surveillance and LACEN/ES agreed to investigate influenza-like illness cases in all LTCFs in the city during the pandemic using a molecular panel. In early February 2021, the LTCF had 67 residents, of whom 25 developed influenza-like illness symptoms and were isolated: 16 male and 9 female. The predominant age group was 80 years and older (10), followed by 70–79 years (8) and 60–69 years (7). Comorbidities included cardiovascular disease (11), diabetes mellitus (5), neurological disease (1), and three smokers. All 25 symptomatic residents had a swab result negative for SARS-CoV-2 by RT-PCR, and 56% (14) had detectable RSV by RT-PCR. The remaining 11 symptomatic individuals were likely RSV, given that symptoms occurred during the outbreak. The attack rate ranged from 20.8% (confirmed cases) to 37.5% (including probable cases). Among the 14 confirmed cases, 4 were hospitalized (all >70 years) and 1 died (the most severe, with at least two comorbidities). The lack of rapid tests for RSV makes more frequent use of molecular testing necessary to assess its prevalence. The attack rate in this study was high. All patients were vaccinated for influenza and COVID-19. At least in LTCFs, incorporating RSV vaccination for older adults is necessary. The timing of this outbreak (summer) shows that RSV seasonality is variable in Brazil.
Burian et al. (2026) studied this question.