Respiratory syncytial virus outbreak on an adult stem cell transplant unit

Sean G. Kelly*, Kristen Metzger, Maureen K Bolon, Christina Silkaitis, Mary Mielnicki, Jane Cullen, Melissa Rooney, Timothy Blanke, Alaa Eddin Tahboub, Gary A Noskin, Teresa R Zembower

*Corresponding author for this work

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background An increase in respiratory syncytial virus type B (RSV-B) infections was detected on an adult hematology/oncology and stem cell transplant unit during March 2015. This prompted an outbreak investigation. Methods Nosocomial cases were defined as RSV-B–positive patients who developed respiratory virus symptoms ≥ 7 days after admission to the unit or were readmitted with symptoms ≤ 7 days since last discharge from the unit. Strict outbreak control measures were implemented to stop the outbreak. Results During the outbreak, 19 cases of RSV-B were detected, 14 among patients and 5 among health care workers (HCWs). Additionally, 2 HCWs tested positive for respiratory syncytial virus type A and 1 tested positive for influenza B among the 27 symptomatic HCWs evaluated. No specific antiviral therapy was given and all cases recovered without progression to lower respiratory tract infection. After no new cases were identified for 2 weeks, the outbreak was declared over. Conclusions High vigilance for respiratory viruses on high-risk inpatient units is required for detection and prevention of potential outbreaks. Multiple respiratory viruses with outbreak potential were identified among HCWs. HCWs with respiratory virus symptoms should not provide direct patient care. Absence of lower respiratory tract infection suggests lower virulence of RSV-B, compared with respiratory syncytial virus type A, among immunocompromised adults.

Original languageEnglish (US)
Pages (from-to)1022-1026
Number of pages5
JournalAmerican Journal of Infection Control
Volume44
Issue number9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Adult Stem Cells
Respiratory Syncytial Viruses
Disease Outbreaks
Transplants
Delivery of Health Care
Viruses
Respiratory Tract Infections
Respiratory Syncytial Virus Infections
Hematology
Human Influenza
Antiviral Agents
Virulence
Inpatients
Patient Care
Stem Cells

Keywords

  • Health care epidemiology
  • Hematopoietic stem cell transplantation

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Kelly, Sean G. ; Metzger, Kristen ; Bolon, Maureen K ; Silkaitis, Christina ; Mielnicki, Mary ; Cullen, Jane ; Rooney, Melissa ; Blanke, Timothy ; Tahboub, Alaa Eddin ; Noskin, Gary A ; Zembower, Teresa R. / Respiratory syncytial virus outbreak on an adult stem cell transplant unit. In: American Journal of Infection Control. 2016 ; Vol. 44, No. 9. pp. 1022-1026.
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abstract = "Background An increase in respiratory syncytial virus type B (RSV-B) infections was detected on an adult hematology/oncology and stem cell transplant unit during March 2015. This prompted an outbreak investigation. Methods Nosocomial cases were defined as RSV-B–positive patients who developed respiratory virus symptoms ≥ 7 days after admission to the unit or were readmitted with symptoms ≤ 7 days since last discharge from the unit. Strict outbreak control measures were implemented to stop the outbreak. Results During the outbreak, 19 cases of RSV-B were detected, 14 among patients and 5 among health care workers (HCWs). Additionally, 2 HCWs tested positive for respiratory syncytial virus type A and 1 tested positive for influenza B among the 27 symptomatic HCWs evaluated. No specific antiviral therapy was given and all cases recovered without progression to lower respiratory tract infection. After no new cases were identified for 2 weeks, the outbreak was declared over. Conclusions High vigilance for respiratory viruses on high-risk inpatient units is required for detection and prevention of potential outbreaks. Multiple respiratory viruses with outbreak potential were identified among HCWs. HCWs with respiratory virus symptoms should not provide direct patient care. Absence of lower respiratory tract infection suggests lower virulence of RSV-B, compared with respiratory syncytial virus type A, among immunocompromised adults.",
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Kelly, SG, Metzger, K, Bolon, MK, Silkaitis, C, Mielnicki, M, Cullen, J, Rooney, M, Blanke, T, Tahboub, AE, Noskin, GA & Zembower, TR 2016, 'Respiratory syncytial virus outbreak on an adult stem cell transplant unit', American Journal of Infection Control, vol. 44, no. 9, pp. 1022-1026. https://doi.org/10.1016/j.ajic.2016.03.075

Respiratory syncytial virus outbreak on an adult stem cell transplant unit. / Kelly, Sean G.; Metzger, Kristen; Bolon, Maureen K; Silkaitis, Christina; Mielnicki, Mary; Cullen, Jane; Rooney, Melissa; Blanke, Timothy; Tahboub, Alaa Eddin; Noskin, Gary A; Zembower, Teresa R.

In: American Journal of Infection Control, Vol. 44, No. 9, 01.09.2016, p. 1022-1026.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Respiratory syncytial virus outbreak on an adult stem cell transplant unit

AU - Kelly, Sean G.

AU - Metzger, Kristen

AU - Bolon, Maureen K

AU - Silkaitis, Christina

AU - Mielnicki, Mary

AU - Cullen, Jane

AU - Rooney, Melissa

AU - Blanke, Timothy

AU - Tahboub, Alaa Eddin

AU - Noskin, Gary A

AU - Zembower, Teresa R

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background An increase in respiratory syncytial virus type B (RSV-B) infections was detected on an adult hematology/oncology and stem cell transplant unit during March 2015. This prompted an outbreak investigation. Methods Nosocomial cases were defined as RSV-B–positive patients who developed respiratory virus symptoms ≥ 7 days after admission to the unit or were readmitted with symptoms ≤ 7 days since last discharge from the unit. Strict outbreak control measures were implemented to stop the outbreak. Results During the outbreak, 19 cases of RSV-B were detected, 14 among patients and 5 among health care workers (HCWs). Additionally, 2 HCWs tested positive for respiratory syncytial virus type A and 1 tested positive for influenza B among the 27 symptomatic HCWs evaluated. No specific antiviral therapy was given and all cases recovered without progression to lower respiratory tract infection. After no new cases were identified for 2 weeks, the outbreak was declared over. Conclusions High vigilance for respiratory viruses on high-risk inpatient units is required for detection and prevention of potential outbreaks. Multiple respiratory viruses with outbreak potential were identified among HCWs. HCWs with respiratory virus symptoms should not provide direct patient care. Absence of lower respiratory tract infection suggests lower virulence of RSV-B, compared with respiratory syncytial virus type A, among immunocompromised adults.

AB - Background An increase in respiratory syncytial virus type B (RSV-B) infections was detected on an adult hematology/oncology and stem cell transplant unit during March 2015. This prompted an outbreak investigation. Methods Nosocomial cases were defined as RSV-B–positive patients who developed respiratory virus symptoms ≥ 7 days after admission to the unit or were readmitted with symptoms ≤ 7 days since last discharge from the unit. Strict outbreak control measures were implemented to stop the outbreak. Results During the outbreak, 19 cases of RSV-B were detected, 14 among patients and 5 among health care workers (HCWs). Additionally, 2 HCWs tested positive for respiratory syncytial virus type A and 1 tested positive for influenza B among the 27 symptomatic HCWs evaluated. No specific antiviral therapy was given and all cases recovered without progression to lower respiratory tract infection. After no new cases were identified for 2 weeks, the outbreak was declared over. Conclusions High vigilance for respiratory viruses on high-risk inpatient units is required for detection and prevention of potential outbreaks. Multiple respiratory viruses with outbreak potential were identified among HCWs. HCWs with respiratory virus symptoms should not provide direct patient care. Absence of lower respiratory tract infection suggests lower virulence of RSV-B, compared with respiratory syncytial virus type A, among immunocompromised adults.

KW - Health care epidemiology

KW - Hematopoietic stem cell transplantation

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