Kelly Sean G, Metzger Kristen, Bolon Maureen K, Silkaitis Christina, Mielnicki Mary, Cullen Jane, Rooney Melissa, Blanke Timothy, Tahboub AlaaEddin, Noskin Gary A, Zembower Teresa R
Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Healthcare Epidemiology and Infection Prevention, Northwestern Memorial Hospital, Chicago, IL.
Am J Infect Control. 2016 Sep 1;44(9):1022-6. doi: 10.1016/j.ajic.2016.03.075. Epub 2016 Jul 15.
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.
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.
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.
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.
2015年3月，在一个成人血液学/肿瘤学及干细胞移植病房中，检测到B型呼吸道合胞病毒（RSV-B）感染增加。这促使开展了一次疫情调查。
医院感染病例定义为在入住该病房≥7天后出现呼吸道病毒症状的RSV-B阳性患者，或自上次从该病房出院≤7天内再次入院且伴有症状的患者。实施了严格的疫情控制措施以阻止疫情爆发。
在疫情爆发期间，共检测到19例RSV-B感染病例，其中患者14例，医护人员（HCW）5例。此外，在接受评估的27例有症状的医护人员中，2例A型呼吸道合胞病毒检测呈阳性，1例B型流感病毒检测呈阳性。未给予特异性抗病毒治疗，所有病例均康复，未进展为下呼吸道感染。在连续2周未发现新病例后，宣布疫情结束。
高危住院病房需要对呼吸道病毒保持高度警惕，以检测和预防潜在疫情爆发。在医护人员中发现了多种具有爆发潜力的呼吸道病毒。有呼吸道病毒症状的医护人员不应直接护理患者。与A型呼吸道合胞病毒相比，在免疫功能低下的成年人中，RSV-B未出现下呼吸道感染提示其毒力较低。
