Impact and prevention of respiratory viruses among nursing home residents

Older adults residing in long-term care facilities (LTCFs), such as nursing homes (NHs), are at high risk of acute respiratory infections (ARIs). In NHs, the best-known viruses causing ARI are influenza viruses, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Less is known about other respiratory viruses, such as human rhinovirus, human metapneumovirus (hMPV), parainfluenza viruses, and seasonal human coronaviruses (HCoVs). As a result, current clinical guidelines for ARIs in NHs mainly focus on influenza viruses, SARS-CoV-2, and RSV. Other respiratory viruses are not routinely tested for, so infections with these viruses often go unnoticed and their consequences remain unclear.
The overall aim of this thesis was to contribute to a better understanding of the impact of respiratory viruses on NH residents. The research described in this thesis encompasses (1) a comprehensive review of the current knowledge from the literature, identifying several knowledge gaps; (2) a two-year prospective cohort study investigating the relative clinical impact of respiratory viruses on Dutch NH residents, in order to address some of these gaps; (3) a comparison of the distribution of respiratory viruses and detection of increased respiratory virus circulation in NHs and the general population, amongst others to explore the possibility of early warning surveillance for NHs; and (4) a mixed-method study to better understand NH healthcare workers’ (HCWs’) perceptions, facilitators, and barriers to influenza and COVID-19 vaccination willingness, in order to identify possible ways to enhance vaccine uptake.