Abstract
Hospital acquired infections with respiratory syncytial virus are a major problem. The virus is spread predominantly by infected nasal secretions and we investigated whether we could reduce its incidence by cohorting babies on each ward into designated areas and encouraging staff and parents to wash their hands. We examined the incidence of hospital acquired infection due to respiratory syncytial virus in all children less than 2 years old and in those with congenital heart disease. In 1986-7, before any intervention, 18 (4.2%) of 425 hospitalised children less than 2 years old developed hospital acquired infection due to respiratory syncytial virus. In 1987-8, after intervention, five (0.6%) of 840 children developed hospital acquired infection but there were fewer ward admissions with community acquired infections due to the virus. In 1988-9, when there were more community acquired infections than 1986-7, six (1.1%) of 552 children developed hospital acquired infection. In 1986-7, eight (34.8%) of 23 children less than 2 years old with congenital heart disease developed hospital acquired infection due to respiratory syncytial virus; all eight were among 11 children with congenital heart disease hospitalised for more than 14 days. In 1987-8, one (3.3%) of 30 children with congenital heart disease developed hospital acquired infection due to respiratory syncytial virus and in 1988-9 there was one (2.1%) case out of 47 children with congenital heart disease. Handwashing and cohorting significantly reduce the incidence of nosocomial respiratory syncytial virus infection.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abman S. H., Ogle J. W., Butler-Simon N., Rumack C. M., Accurso F. J. Role of respiratory syncytial virus in early hospitalizations for respiratory distress of young infants with cystic fibrosis. J Pediatr. 1988 Nov;113(5):826–830. doi: 10.1016/s0022-3476(88)80008-8. [DOI] [PubMed] [Google Scholar]
- Gala C. L., Hall C. B., Schnabel K. C., Pincus P. H., Blossom P., Hildreth S. W., Betts R. F., Douglas R. G., Jr The use of eye-nose goggles to control nosocomial respiratory syncytial virus infection. JAMA. 1986 Nov 21;256(19):2706–2708. [PubMed] [Google Scholar]
- Garner J. S., Simmons B. P. Guideline for isolation precautions in hospitals. Infect Control. 1983 Jul-Aug;4(4 Suppl):245–325. [PubMed] [Google Scholar]
- Hall C. B., Douglas R. G., Jr, Geiman J. M., Messner M. K. Nosocomial respiratory syncytial virus infections. N Engl J Med. 1975 Dec 25;293(26):1343–1346. doi: 10.1056/NEJM197512252932604. [DOI] [PubMed] [Google Scholar]
- Hall C. B., Douglas R. G., Jr, Geiman J. M. Possible transmission by fomites of respiratory syncytial virus. J Infect Dis. 1980 Jan;141(1):98–102. doi: 10.1093/infdis/141.1.98. [DOI] [PubMed] [Google Scholar]
- Hall C. B., Douglas R. G., Jr, Geiman J. M. Respiratory syncytial virus infections in infants: quantitation and duration of shedding. J Pediatr. 1976 Jul;89(1):11–15. doi: 10.1016/s0022-3476(76)80918-3. [DOI] [PubMed] [Google Scholar]
- Hall C. B., Douglas R. G., Jr Modes of transmission of respiratory syncytial virus. J Pediatr. 1981 Jul;99(1):100–103. doi: 10.1016/s0022-3476(81)80969-9. [DOI] [PubMed] [Google Scholar]
- Hall C. B., Powell K. R., MacDonald N. E., Gala C. L., Menegus M. E., Suffin S. C., Cohen H. J. Respiratory syncytial viral infection in children with compromised immune function. N Engl J Med. 1986 Jul 10;315(2):77–81. doi: 10.1056/NEJM198607103150201. [DOI] [PubMed] [Google Scholar]
- Hendley J. O., Wenzel R. P., Gwaltney J. M., Jr Transmission of rhinovirus colds by self-inoculation. N Engl J Med. 1973 Jun 28;288(26):1361–1364. doi: 10.1056/NEJM197306282882601. [DOI] [PubMed] [Google Scholar]
- Isaacs D., Bangham C. R., McMichael A. J. Cell-mediated cytotoxic response to respiratory syncytial virus in infants with bronchiolitis. Lancet. 1987 Oct 3;2(8562):769–771. doi: 10.1016/s0140-6736(87)92502-5. [DOI] [PubMed] [Google Scholar]
- Leclair J. M., Freeman J., Sullivan B. F., Crowley C. M., Goldmann D. A. Prevention of nosocomial respiratory syncytial virus infections through compliance with glove and gown isolation precautions. N Engl J Med. 1987 Aug 6;317(6):329–334. doi: 10.1056/NEJM198708063170601. [DOI] [PubMed] [Google Scholar]
- MacDonald N. E., Hall C. B., Suffin S. C., Alexson C., Harris P. J., Manning J. A. Respiratory syncytial viral infection in infants with congenital heart disease. N Engl J Med. 1982 Aug 12;307(7):397–400. doi: 10.1056/NEJM198208123070702. [DOI] [PubMed] [Google Scholar]
- Philip A. G., Long J. G., Donn S. M. Intracranial pressure. Sequential measurements in full-term and preterm infants. Am J Dis Child. 1981 Jun;135(6):521–524. [PubMed] [Google Scholar]
- Taylor C. E., Morrow S., Scott M., Young B., Toms G. L. Comparative virulence of respiratory syncytial virus subgroups A and B. Lancet. 1989 Apr 8;1(8641):777–778. doi: 10.1016/s0140-6736(89)92592-0. [DOI] [PubMed] [Google Scholar]