Molecular characteristics and successful management of a respiratory syncytial virus outbreak among pediatric patients with hemato-oncological disease

Antimicrob Resist Infect Control. 2018 Feb 13:7:21. doi: 10.1186/s13756-018-0316-2. eCollection 2018.

Abstract

Background: Respiratory syncytial virus (RSV) is responsible for upper and lower respiratory tract infection in adults and children. Especially immunocompromised patients are at high risk for a severe course of infection, and mortality is increased. Moreover RSV can spread in healthcare settings and can cause outbreaks. Herein we demonstrate the successful control and characteristics of a RSV outbreak that included 8 patients in our Department of Pediatric Hematology and Oncology.

Methods: We performed an epidemiologic investigation and a molecular analysis of the outbreak strains. Moreover we present the outbreak control bundle and our concept for RSV screening in the winter season.

Results: RSV A and B strains caused the outbreak. RSV B strains affected 3 patients, 2 of whom were co-infected with RSV A. Exactly this RSV A strain was detected in another 5 patients. Our multimodal infection control bundle including prophylactic RSV screening was able to rapidly stop the outbreak.

Conclusion: An infection control bundle in RSV outbreaks should address all potential transmission pathways. In pediatric settings the restriction of social activities might have a temporal negative impact on quality of life but helps to limit transmission opportunities. Molecular analysis allows better understanding of RSV outbreaks and, if done in a timely manner, might be helpful for guidance of infection control measures.

Keywords: Cancer patients; Hematology and oncology; Infection control; Molecular typing; Outbreak; Pediatric patients; RSV; Respiratory syncytial virus.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cross Infection / epidemiology
  • Cross Infection / virology
  • DNA, Viral / genetics
  • Disease Outbreaks*
  • Female
  • Germany / epidemiology
  • Hematologic Neoplasms / complications*
  • Humans
  • Immunocompromised Host
  • Infant
  • Infection Control
  • Male
  • Molecular Epidemiology
  • Molecular Typing
  • Quality of Life
  • Respiratory Syncytial Virus Infections / diagnosis
  • Respiratory Syncytial Virus Infections / epidemiology*
  • Respiratory Syncytial Virus Infections / virology*
  • Respiratory Syncytial Virus, Human / classification
  • Respiratory Syncytial Virus, Human / genetics*
  • Respiratory Syncytial Virus, Human / isolation & purification
  • Respiratory Syncytial Virus, Human / pathogenicity*
  • Respiratory Tract Infections / virology*
  • Virus Shedding

Substances

  • DNA, Viral