Respiratory syncytial virus outbreak on an adult stem cell transplant unit

Sean G Kelly1, Kristen Metzger2, Maureen K Bolon3

  • 1Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.

Abstract

Insights

An outbreak of respiratory syncytial virus type B (RSV-B) occurred in an adult hematology/oncology unit. Vigilance and prompt control measures contained the RSV-B outbreak, highlighting the need for monitoring respiratory viruses in high-risk settings.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Hospital Epidemiology

Background:

  • An increase in respiratory syncytial virus type B (RSV-B) infections was observed in March 2015 on an adult hematology/oncology and stem cell transplant unit.
  • This increase prompted an investigation into a potential nosocomial outbreak.

Purpose of the Study:

  • To investigate an outbreak of RSV-B on a high-risk inpatient unit.
  • To identify the scope of the outbreak and implement control measures.
  • To understand the characteristics of RSV-B infections in immunocompromised adults.

Main Methods:

  • Defined nosocomial RSV-B cases based on symptom onset and admission/discharge dates.
  • Implemented strict outbreak control measures.
  • Monitored patient and healthcare worker (HCW) infections, including other respiratory viruses.

Main Results:

  • Nineteen cases of RSV-B were detected: 14 patients and 5 HCWs.
  • Two HCWs tested positive for RSV-A, and one for influenza B.
  • All cases recovered without progression to lower respiratory tract infection; the outbreak was declared over after 2 weeks with no new cases.

Conclusions:

  • High vigilance for respiratory viruses on inpatient units is crucial for outbreak detection and prevention.
  • HCWs can harbor and transmit multiple respiratory viruses; symptomatic HCWs should not provide direct patient care.
  • RSV-B may exhibit lower virulence than RSV-A in immunocompromised adults, as evidenced by the absence of lower respiratory tract infections.

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