An outbreak of RSV infections in a neonatology clinic during the RSV-season

Abstract

Background Respiratory syncytial virus (RSV) is the predominant cause of lower respiratory tract infections (LRTI) in infancy. Preterm infants with bronchopulmonary dysplasia (BPD) are at the highest risk of severe RSV-LRTI. This is a retrospective study that analyses a nosocomial outbreak of RSV infections in the Neonatology clinic of the University Hospital of Obstetrics and Gynecology, Sofia, 2019. Methods Two groups of infants without contact between them were diagnosed with RSV-infection: 14 infants were treated in the Department for healthy newborns – Group 1, and 7 preterm infants were treated in the Neonatal Intensive Care Unit (NICU) – Group 2. The detection of RSV was performed using Real-Time PCR in nasal/throat swabs. Results Respiratory symptoms occurred 2–5 days after discharge in 14 of 148 healthy term infants born February 5 to 18, 2019; 12 babies were re-hospitalized with LRTI and recovered in a few days. RSV-PCR was positive in 6 infants, while in the others, RSV etiology was suggested, due to similar symptoms and contact between them. The first NICU patient with RSV-LRTI was one of the 26 gestational weeks (GW) twins, who had severe BPD. The other twin was always discharged home without LRTI-symptoms. In the period February 19 to March 15, 2019, 26 premature babies born at 26–34 GW, were tested for RSV (33 nasal/throat swabs). They received a first or subsequent palivizumab injection. We identified 11 positive samples in 7 of the babies. Despite the clinical recovery, the second RSV-PCR remained positive in 4 babies. Six of the 7 NICU patients had symptoms of LRTI, and two of them needed mechanical ventilation. Six babies were discharged home after stabilization, one was transferred to the Pediatric department for further treatment of BPD and later discharged too. Conclusions This was the most serious outbreak of RSV infections in neonates since the RSV-PCR diagnostic in Bulgaria was introduced. The course of RSV-LRTI was severe in extremely preterm patients with underlying BPD. So, routine in-hospital RSV-prophylaxis with palivizumab should be considered for infants at the highest risk.

A delayed resurgence of respiratory syncytial virus (RSV) during the COVID‐19 pandemic: An unpredictable outbreak in a small proportion of children in the Southwest of Iran, April 2022

“…This virus antigenically falls within RSV‐A and RSV‐B subtypes 3 . The virus has been recognized as a major responsible pathogen to cause lower respiratory tract infections (LRTI), for instance, pneumonia (hospital admission rate: 5%−40%), tracheobronchitis (hospital admission rate: 10%−30%), and is the most medically important agent for acute bronchiolitis (hospital admission rate: 50%−90%) in children 4 . An estimation of the global burden of virus‐associated acute LRTI in 2019 linked RSV to 25.4–44.6 million infection episodes, 2.9–4.6 million hospitalizations, and 15 100–49 100 deaths in hospitalized children below the age of 2 years 5 .…”

Neonates in pediatric emergency department. Comparative study of bronchiolitis with other pathologies that required hospitalization

“…La mediana de edad fue similar al encontrado en el estudio uruguayo (10). Los brotes de bronquiolitis, reportados en neonatos con menor edad y hospitalizados en las unidades neonatales, frecuentemente por el Virus sincitial respiratorio (VSR) , tienen una elevada morbimortalidad (16) Similar a un estudio latinoamericano (17) la gran mayoría de los pacientes con bronquiolitis residían en zonas urbanas, comparando con los pacientes ingresados con otros diagnósticos. Esta situación puede estar relacionada a la mayor exposición humo ambiental, principalmente quema de residuos, de los neonatos con bronquiolitis.…”

Immune escaping of the novel genotypes of human respiratory syncytial virus based on gene sequence variation

“…Nasopharyngeal swabs and serum samples were collected from pediatric patients who met the following criteria (1): diagnosed with “bronchitis”, “bronchiolitis”, or “pneumonia” (2); respiratory specimens positive for RSV tested by DFA (Diagnostic Hybrids, Athens, OH, USA), and further identified for subtype and genotype of RSV by sequence analysis ( 3 , 15 ). had at least one serum sample: the first was collected on days 0 to 3, and the second was collected on days 5 to 7 after the onset of the disease.…”

“…The global burden of virus-associated acute lower respiratory tract infections in 2019 linked RSV to 25.4 million to 44.6 million infections, 2.9 million to 4.6 million hospitalizations, and 15100 to 49100 deaths in hospitalized children under the age of 2 years ( 2 ). In infants, RSV infection is the most common cause of bronchiolitis and pneumonia ( 3 ). A clear health burden of RSV and high severity of RSV infection were found even in influenza season ( 4 ).…”