| Methods |
Controlled before and after study with economic evaluation (data not extracted) carried out over 8 RSV seasons in 1988 to 1996. The study assessed the impact of a programme for the interruption of transmission of RSV in a children hospital in Philadelphia, USA. Analyses are presented both by risk group (exposure to patients by days of viral shedding) and as aggregate. Only for the latter numerators and denominators are provided, whereas for the former figures are presented in bar chart format |
| Participants |
Children with community‐acquired RSV infection and the inpatient children exposed to them (1604 in 4 seasons before and 2065 in the "after the intervention" seasons. Children were aged around 1 year and those with risk factors were equally spread (51% versus 54%) in the 2 periods |
| Interventions |
Education with high index of suspicion for case‐finding with barriers (but no goggles or masks) and handwashing for patients and staff with contact precautions for RSV + patients for 2 weeks with isolation (when possible) with cohorting of patients and staff with enhanced surveillance with restriction of visits with discouragement of staff with ARIs from working unprotected in SCBU |
| Outcomes |
Laboratory: ELISA confirmation of RSV infection on all children admitted with respiratory symptoms. In a proportion of cases RSV culture was undertaken, although this had a minimal practical impact as any child with respiratory symptoms was considered as a RSV case
Effectiveness: clinically‐defined RSV cases contracted nosocomially (with symptoms appearing after at least 6 days from admission)
Safety: N/A |
| Notes |
Risk of bias: low
Notes: the authors conclude that 10 RSV infections were prevented per season (RR for post‐intervention compared to pre‐intervention periods 0.61, 95% CI 0.53 to 0.69). The study is well‐reported and the conclusions appear reasonable, but no information is given on the background rate of infection and the impact of the intervention on HCW morbidity is not analysed |
| 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 |
