| Methods |
Cohort study to determine the possible modes of spread a RSV to young adult volunteers working on a paediatric ward who were exposed in different manners to infants with RSV. Volunteers were divided into 3 groups: "cuddlers", exposed to an infected infant over 2 to 4 hours by caring for the baby in the usual manner, wearing gowns, but no mask or gloves; "touchers", exposed with the infant out of the room by touching surfaces contaminated with the baby's secretions; "sitters", exposed to an infected baby by sitting at a distance of more than 6 feet from an infant's bed, and they wore gowns and gloves, but no masks. In order to control for possible differences in infectivity among infants, a volunteer from each of the 3 groups was exposed to each infant, or to this environment in the case of touchers. In addition, volunteers from each group were exposed to more than one infant. After exposure volunteers were followed for 12 days |
| Participants |
31 volunteers: 7 in the cuddler group, 10 in toucher group and 14 in the sitter group |
| Interventions |
Exposure to infants admitted with bronchiolitis or pneumonia during a community outbreak of RSV isolation |
| Outcomes |
Laboratory: serological evidence
Effectiveness: RSV infection demonstrated by viral isolation and serology. Clinical symptom diary collected with questionnaires. Symptomatic, asymptomatic and febrile symptomatic data reported separately
Safety: n/a |
| Notes |
Risk of bias: low
Notes: the authors concluded that the spread of RSV may occur by close contact with direct inoculation of large droplets or by self‐inoculation after touching contaminated surfaces. Infection does not appear to occur after more distant contact requiring small particle aerosols (0 infected out of 14 "sitters", those that sat away from RSV infected infants, compared with 5 out of 7 who cuddled and 4 out of 10 who touched the infected infants). Ancillary procedures that may be helpful include the care of contaminated surfaces and gowns, cohorting of staff and infants, and limiting the traffic in and out of the infants' room. With limited facilities, isolation rooms might best be reserved for uninfected infants with underlying disease who, should they acquire nosocomial RSV infection, are at risk for severe disease |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Unclear risk |
N/A |
| Allocation concealment (selection bias) |
Unclear risk |
N/A |
| Blinding (performance bias and detection bias)
All outcomes |
Unclear risk |
N/A |
| Incomplete outcome data (attrition bias)
All outcomes |
Unclear risk |
N/A |
| Selective reporting (reporting bias) |
Unclear risk |
N/A |
