355. Respiratory Syncytial Virus Outbreak on a Stem Cell Transplant Unit
Session: Poster Abstract Session: HAI: Respiratory Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • RSVPoster9-28.pdf (255.8 kB)
  • Background: In March of 2015, an increase in respiratory syncytial virus type B (RSV-B) infections was detected among patients on the inpatient Hematology/Oncology and Stem Cell Transplant unit of an academic medical center in Chicago, IL. Therefore, an outbreak investigation was initiated.

    Methods: Nosocomial cases were defined in patients who developed respiratory virus symptoms ≥7 days after admission and tested positive for RSV-B by polymerase chain reaction (PCR).The following outbreak control measures were implemented: 1) universal mask precautions 2) contact and droplet precautions for suspected and confirmed cases 3) strict RSV cohorting 4) weekly screening of all patients with PCR 5) daily symptom assessment of all patients 6) universal testing of all healthcare teams, followed by targeted testing of symptomatic staff 7) influenza-like illness (ILI) screening of all HCWs and visitors prior to unit entry 8) visitor restrictions 9) closure of family lounges. Clinical and demographic data were collected on all patients.

    Results: Between 3/3/15 and 4/9/15, a total of 14 patients were identified with nosocomial RSV-B infections. 11 (79%) had cough, 10 (71%) had fever, 6 (43%) had nasal congestion. 13 (93%) received hematopoietic stem cell transplants (HSCTs) (50% for underlying hematologic malignancy, 50% for underlying autoimmune disease). Among 27 symptomatic HCWs who were sent for evaluation at Corporate Health, 5 tested positive for RSV-B, 2 tested positive for RSV-A and 1 tested positive for influenza B. Among the HCWs with RSV-B, 100% had nasal congestion, 3 (60%) had cough, and none had fever. No specific antiviral therapy was given and all cases recovered. After no new cases were identified for 2 weeks, the outbreak was declared over.

    Conclusion: High vigilance for respiratory viruses on inpatient units with immunocompromised patients is required for early detection and prevention of potential outbreaks. Implementation of strict infection control measures is required to eliminate outbreaks. Multiple respiratory viruses with outbreak potential were identified among HCWs; HCWs with symptoms of respiratory viral illness should not provide direct patient care.

     

    Sean Kelly, MD1, Kristen Metzger, MPH, CIC2, Maureen Bolon, MD, MS1,2, Christina Silkaitis, MT (ASCP), CIC2, Maribeth Mielnicki, MSN, RN, NE-BC3, Jane Cullen, MD4, Melissa Rooney, BA, RN4, Timothy Blanke, BS (ASPC)5, Alaaeddin Tahboub, MS5, Gary Noskin, MD, FSHEA1 and Teresa Zembower, MD, MPH, FIDSA1,2, (1)Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, (2)Healthcare Epidemiology and Infection Prevention, Northwestern University, Chicago, IL, (3)Oncology Services, Northwestern Memorial Hospital, Chicago, IL, (4)Corporate Health and Travel at Northwestern Memorial Hospital, Northwestern University, Chicago, IL, (5)Diagnostic Molecular Biology, Northwestern University, Chicago, IL

    Disclosures:

    S. Kelly, None

    K. Metzger, None

    M. Bolon, None

    C. Silkaitis, None

    M. Mielnicki, None

    J. Cullen, None

    M. Rooney, None

    T. Blanke, None

    A. Tahboub, None

    G. Noskin, None

    T. Zembower, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.