Table 1.
Studies reporting on the nosocomial RSV transmission risk (research question one), ordered by hospital setting
| Author, publication year | Country, year of outbreak | Hospital setting | Study objectivea | Nosocomial cases/patients at risk (%) | Infection control measuresb |
|---|---|---|---|---|---|
| Alan, 201228 | Turkey, 2012 | Neonatal | To report on palivizumab use to control an RSV outbreak | 1/16 (6·3) | Unclear; ‘strict contact measures’ for all patients given palivizumab; index cases cared for in separate isolation rooms |
| Boedy, 198829 | NC; assume USA, NS | Neonatal | Reports on containment, therapy and cost of a nosocomial RSV outbreak | 8/35 (22·9) | Contact isolation, transfer of affected infants to separate unit to be cared for by infected healthcare workers, ribavirin treatment in 7 of 8 cases (for 3–5 days) |
| Dizdar, 201019 | Turkey, 2009 | Neonatal | Reports an RSV outbreak in a NICU detected during a screening trial for RSV infection | 15/50 (30·0) | Cohorting, gloves, gowns and masks, unit closed to elective admissions, visiting restrictions, screening of symptomatic staff, palivizumab prophylaxis |
| Halasa, 200530 | USA, 2002 | Neonatal | To assess the medical and economic impact of a RSV outbreak in a NICU | 9/56 (16·1) | Testing of all infants, isolation of infected infants, gowns and gloves, handwashing, palivizumab prophylaxis for all non‐infected infants, restriction of visiting policy (none <13 years), exclusion of staff and visitors with respiratory symptoms, NICU closed to non‐emergency admissions, infants who had been RSV‐positive were kept separated from non‐infected infants for 3 weeks, emergency admissions in room not occupied by those infected, RSV‐negative infants with respiratory symptoms isolated from other infants for 8 days |
| Kilani, 200231 | Saudi Arabia, 1999 | Neonatal | To describe an RSV outbreak in a NICU and its successful control by infection control measures | 8/20 (40·0) | Screening of all staff and infants, index cases isolated, evacuated rooms cleaned and fumigated, infant and staff cohorting, universal precautions with strict adherence to gowns/masks/gloves |
| Kokstein, 200132 | Czech Republic, 2000 | Neonatal | Describes an RSV outbreak in a NICU | 5/9 (55·6) | Barrier nursing, palivizumab for highest risk neonates |
| Kurz, 200833 | Austria, 2007 | Neonatal | Reports on experience of using palivizumab and infection control measures to prevent RSV outbreaks in NICU | 1/11 (9·1) | NICU closed to new admissions, masks, gloves and gowns used in care of all patients, visits restricted to mothers only (using gloves and masks); palivizumab administered to all patients |
| Meissner, 198434 | USA, 1982 | Neonatal | Reports on a simultaneous outbreak of RSV and parainfluenza virus type 3 in a newborn nursery | 9/34 (26·5) | Cohorting of infants and staff, ward closed to new admissions |
| Mintz, 197935 | USA, 1978 | Neonatal | Reports on direct immunofluorescence to rapidly identify infants with RSV infection | 7/17 (41·1) | RSV fluorescent antibody screening and viral cultures performed on all patients, patient isolation, strict handwashing, gowning and gloving procedures (masking was not required), cohort nursing, staff with upper respiratory symptoms were allowed to care for infected infants |
| Silva, 201220 | Brazil, 2010 | Neonatal | To report on infection control measures and passive immunotherapy to control an RSV outbreak | 10/18 (55·6) | Cohorting, masks, prophylaxis with palivizumab, immunoassay testing |
| Visser, 200836 | South Africa, 2006 | Neonatal | To describe the molecular epidemiological investigation of an outbreak of RSV‐associated pneumonia | 23/44 (52·3) | None specified |
| Salecedo, 200038 | Spain, 2000 | Neonatal | Reports on the use of palivizumab prophylaxis to control an RSV outbreak | 4/60 (6·6) | Palivizumab prophylaxis |
| White, 199027 | UK, 1990 | Neonatal | To report on an RSV outbreak in a special care nursery | 4/12 (33·3) | Isolation and cohort nursing, unit closed to admission for 2 days, new admissions separated from all existing admissions (infected or potentially infected), repeated screening of potentially infected babies, nurses with respiratory symptoms were designated to care for infected babies. |
| Krause, 197537 | USA, year not specified | Neonatal/paediatric | Reports on hospital staff and inpatient infants for carriage and acquisition of respiratory virus infections | 4/15 (26·7) | None specified |
| Abdallah, 200339 | Australia, 2001 | Adults – haematological cancers and/or bone marrow/stem cell transplant recipients | Describes the outcome of RSV‐infected inpatients during an outbreak | 11/195 (5·6) | Isolation in a single room, handwashing, barrier protection including gowns, gloves and masks (no goggles), cohort nursing, screening for RSV if developed URTI symptoms, with isolation pending results, patients were advised to do the following: catching cough/sneeze, bin it and handwashing; thorough cleaning of patient room after discharge; exclusion of URTI‐symptomatic staff and visitors from patient care or visiting; staff education and written protocol on inpatient RSV management |
| Harrington, 199240 | USA, 1990 | Adults – haematological cancers and/or bone marrow/stem cell transplant recipients | To describe an RSV outbreak in a bone marrow transplant centre | 23/191 (12·0) | Usual universal precautions and additionally, masks for all persons entering room and for outpatients when indoors, RSV‐infected outpatients isolated when outpatient department, family and employees known to be infected excluded from hospital and outpatient department |
| Mangi, 199841 | UK, 1997 | Adults – haematological cancers and/or bone marrow/stem cell transplant recipients | To report an outbreak of RSV infection in an adult leukaemia unit | 4/60 (6·7) | Isolation, no children on ward, handwashing, staff screening |
| Huang, 200942 | Taiwan, 2005 | Adults – other | To report on experience of containing an RSV outbreak in a psychiatric ward | 8/25 (32·0) | Masks, gloves, gowns, handwashing, isolation cubicles, patient information and training, exclusion of staff with early onset symptoms, testing |
| Mandal, 198543 | UK, 1982–1983 | Adults – other | Describes an outbreak of RSV infection in a continuing‐care elderly ward | 8/27 (29·6) | None specified |
RSV, respiratory syncytial virus; NICU, neonatal intensive care unit; URTI, upper respiratory tract infection.
a
Objectives explicitly stated by the study author begin with ‘To…’.
b
Most of these measures were applied in response to the outbreak (although some may have already been in place prior).