1227. Management of a Respiratory Syncytial Virus (RSV) Outbreak in a Pediatric Hematology/Oncology/Transplant Unit without the use of Ribavirin or Palivizumab
Session: Poster Abstract Session: RSV and Other Viral Respiratory Infections in Children
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
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  • Background: Respiratory Syncytial Virus (RSV) is the most common pathogen causing healthcare associated respiratory viral infections (HA-VRI) in hospitalized children.  RSV infection of the lower respiratory tract in patients who have recently received hematopoietic stem cell transplants (HSCT) may be fatal. The lack of evidence-based treatment for RSV infections complicates management. There are limited reports of RSV outbreaks in HSCT units and optimal management strategies have not yet been identified. An outbreak investigation was initiated after a cluster of RSV infections was reported on the 18-bed hematology/oncology unit of our hospital within a 1 week period.

     Methods: A case was defined as any patient admitted to the outbreak unit between 10 January and 14 February, 2011 who tested positive for RSV by routine laboratory methods, after a minimum of 72 hours on the unit. Nasopharyngeal swabs were collected from all patients on the unit. Data were gathered from: laboratory reports, health records, and interviews with staff and families.

      Results: In total, 5 healthcare associated RSV cases were identified; all were male with age range 1-17 years. Two cases had recent allogeneic HSCT for aplastic anemia and acute lymphoblastic leukemia; 1 case with Hurler syndrome was several months post HSCT but highly immunocompromised due to graft versus host disease treatment; 1 case had acute myeloid leukemia and 1 case was being treated for high risk sarcoma.  No cases required intubation and all recovered without complications or death.  Control measures included: enhanced isolation and screening of patients admitted to the unit; enhanced environmental disinfection; limiting visitors/caregivers to 2 healthy adults; closing the ward to non-hematology/oncology patients; postponing social activities; and providing weekly intravenous immune globulin to HSCT patients. Staff were encouraged to stay home if they had symptoms of respiratory tract infection, even if symptoms were mild.  No patients received Ribavirin or Palivizumab.

      Conclusion: Traditional control measures combined with enhanced administrative precautions were adequate in controlling this RSV outbreak. Specific antiviral prophylaxis or treatment was not required.

     


    Subject Category: P. Pediatric and perinatal infections

    Wifaq Al-Shaibani, MD1, Leah Wuitschik, RN2, Mireille Lemay, MD1, Victor Lewis, MD1 and Joseph Vayalumkal, MD1, (1)Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada, (2)Infection Prevention and Control, Alberta Children's Hospital, Calgary, AB, Canada

    Disclosures:

    W. Al-Shaibani, None

    L. Wuitschik, None

    M. Lemay, None

    V. Lewis, None

    J. Vayalumkal, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.