@article{Baglivo_Tecchio_Sidoti_Pecchioli_D’Atri_Casini_Panatto_Massaro_Centrone_Chironna_et al._2026, title={RSV epidemiology in Primary Care in four Italian regions: A prospective multi-center study in over 60-year-old adults across three winter seasons (2022 - 2023 - 2024)}, volume={38}, url={https://mattioli1885journals.com/index.php/annali-igiene/article/view/18238}, DOI={10.7416/ai.2026.18238}, abstractNote={
Background: Respiratory syncytial virus (RSV) is an under-recognised cause of acute respiratory infections (ARIs) in older adults, despite a burden comparable to influenza and the recent availability of RSV vaccines. Robust community-based data from Italian primary care are lacking. Methods: We conducted a prospective, multicentre cohort study in four Italian regions (Liguria, Lombardy, Tuscany, Apulia) over three consecutive winter seasons (2022–2025). Community-dwelling adults ≥60 years presenting to participating general practitioners (GPs) with a WHO-defined ARI were enrolled. Nasopharyngeal swabs were collected and  tested using a multiplex RT-PCR respiratory panel. RSV-positive participants were followed by telephone at day 14 (T14) and day 30 (T30). Adjusted prevalence ratios (PRs) for symptoms were estimated with Poisson regression. Results: Among 664 ARI episodes, 663 had a valid RSV result, and 88 were RSV-positive (13.3%). Positivity rates varied by season (21.7% in 2022–23, 11.9% in 2023–24, and 10.4% in 2024–25) and region (range: 11.2–28.3%), with peaks occurring between ISO weeks 51 and 10. The median age of RSV-positive patients was 75 years (IQR, 68–82); 42% were male. Compared with RSV-negative ARIs, RSV-positive cases had higher adjusted prevalence of cough (PR 1.07, 95% CI 1.02–1.13) and wheezing (PR 1.83, 95% CI 1.14–2.93); other symptoms overlapped substantially. RSV-B predominated (68.2%). Any co-infection occurred in 35.2% of RSV-positive cases, mainly with Haemophilus influenzae and Streptococcus pneumoniae. Median illness duration was 19.5 days (IQR 11.3–30.0). Within 14 days, 65.9% re-contacted their GP and 10.6% sought additional medical care; emergency visits (3.5%) and hospitalisations (2.4%) were uncommon. Conclusions: Across three winters, RSV accounted for approximately one in eight medically attended ARIs in Italian adults ≥60 years, with prolonged illness also leading to hospitalisations and frequent re-consultations. These findings provide baseline data to support adult RSV vaccination policies and integration of RSV into routine respiratory surveillance in Italy.
}, number={1}, journal={Annali di Igiene Medicina Preventiva e di Comunità}, author={Baglivo, Francesco and Tecchio, Federico and Sidoti, Maria and Pecchioli, Matilde and D’Atri, Antonella Lucia and Casini, Beatrice and Panatto, Donatella and Massaro, Elvira and Centrone, Francesca and Chironna, Maria and Pariani, Elena and Pellegrinelli, Laura and Rizzo, Caterina}, year={2026}, month={Feb.}, pages={18238} }