Lack of sensitivity of rapid antigen tests for the diagnosis of respiratory syncytial virus infection in adults.

The diagnosis of respiratory syncytial virus (RSV) infection in older individuals and adults with cardiopulmonary diseases using available rapid antigen detection tests may be difficult due to the low virus shedding in this population. These tests have been extensively evaluated in hospitalized infants, but there is only limited data on their usefulness in adult populations. We evaluated the performance of three different rapid antigen detection tests: Becton Dickinson Directigen RSV (BD), Bartels RSV Direct Fluorescent Antibody Test (DFA) and the VIDAS RSV assay (VIDAS) in nasopharyngeal specimens from 60 older persons with RSV infection documented by cell culture, serology or reverse transcription polymerase chain reaction (RT-PCR). The three rapid antigen assays tested on all 60 samples performed poorly. DFA detected 14 (23%), VIDAS detected 12 (20%) and BD detected only 6 (10%) of the RSV infected persons. Rapid antigen detection tests for the diagnosis of RSV respiratory illness in adults are of limited value.