Point prevalence assessments of five respiratory viruses in adults ≥ 50 years of age in Germany by multi-pathogen rapid antigen testing on June 1, 2024, and December 15, 2024.

PURPOSE: Acute respiratory infections (ARI) impose a significant burden on healthcare systems and society. This study aimed to investigate the circulation of respiratory viruses in community-dwelling older adults in Germany.

METHODS

Participants aged ≥ 50 years in Germany performed multi-pathogen rapid antigen self-tests (MAK5) detecting adenovirus (AdV), severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), influenza A and B, and respiratory syncytial virus (RSV) on June 1 and December 15, 2024. Participants reported test results, ARI symptoms and duration, medical consultations, work absenteeism, comorbidities, vaccination history, and prior infections.

RESULTS

2,654 participants enrolled in the point prevalence assessment on June 1, 2024 and 2,385 on December 15, 2024. Most tests were negative (n = 4,807; 93.9%), with an overall detection rate of 5.7%. In June, 153 pathogens were detected, compared to 138 in December. AdV was the most frequently detected pathogen in both June (59/153; 38.6%) and December (44/138; 31.9%), followed by SARS-CoV-2 and influenza A. Among participants with a positive test, at least one ARI symptom was reported by 47.7% in June and 58.7% in December. SARS-CoV-2 was associated with the highest clinical burden, resulting in healthcare utilization in 10.0% and 19.4% of cases and work absenteeism in 10.0% and 13.9% of cases in June and December, respectively.

CONCLUSION

Point prevalence testing revealed substantial AdV circulation, underrepresented in routine surveillance. Its frequent co-detection with other viruses suggests a role as a co-infecting agent. Community-based screening can help identify asymptomatic reservoirs and underreported viral circulation, linking viral detection to clinical and economic impact.