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.