Objective: To report a serious outbreak of respiratory illness in a nursing home, with isolation of parainfluenza type 3 in four cases.
Design: Viral respiratory cultures from a sample of symptomatic residents, and retrospective chart review.
Setting: A 50-bed nursing unit/floor in a skilled nursing facility.
Participants: All residents of the nursing unit.
Measurements: Respiratory viral cultures and clinical chart review.
Results: Twenty-five of 49 residents developed new respiratory symptoms between September 2 and September 25, 1999. Ten cases (40%) had a tympanic temperature of 100 degrees F or greater. Eighteen (72%) had a chest X-ray with 11 (44%) new infiltrates. Sixteen (64%) were treated with antibiotics. Three cases were hospitalized and four died (16%) within 1 to 9 days after onset of symptoms. Four of 10 viral cultures yielded parainfluenza type 3.
Conclusions: Parainfluenza type 3 may cause outbreaks complicated by pneumonia and fatal outcome. Clinicians should consider uniform secretion precautions to contain all viral URIs in nursing homes.