Influenza and respiratory syncytial virus screening for the detection of asymptomatically infected patients in hematology and oncology

Baier, Claas; Linderkamp, Christin; Beilken, Andreas; Thol, Felicitas; Heuser, Michael; Ebadi, Ella; Ganzenmueller, Tina; Heim, Albert; Bange, Franz-Christoph

doi:10.3205/dgkh000314

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…In our case, the outbreak control management focused explicitly on enforcing the already existing measures, thereby successfully containing the outbreak. The established PCR-based screening program (including influenza) [ 19 ] was helpful in rapid detection of the index patient and patients 3 and 4, both being asymptomatic at the time of the PCR screening. The infection control concept of prevalence and admission screening has also been widely adopted during the COVID-19 pandemic in healthcare facilities.…”

Section: Discussionmentioning

confidence: 99%

“…The infection control concept at our institution for hematology wards regarding RSV is summarized in Table 1 . It was primarily shaped by the management of a previous RSV outbreak in a pediatric setting in our institution [ 10 ] and included a weekly PCR prevalence screening for asymptomatic patients [ 19 ]. This screening also addressed influenza.…”

Section: Methodsmentioning

confidence: 99%

“…Visitors were intensively instructed in droplet precautions and hand hygiene Prophylactic RSV Screening : Newly admitted patients were tested for RSV/Influenza (admission screening). In addition, once weekly a RSV/Influenza screening for all patients on the ward took place (prevalence screening) [ 19 , 20 ] Pre-Season Audits/Training: Training for HCWs provided by the infection control staff prior to the winter season Protective isolation: Nursing in separate rooms for selected patients (e.g., for hematology patients with an expected prolonged and severe leucopenia) …”

Section: Methodsmentioning

confidence: 99%

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Target capture sequencing reveals a monoclonal outbreak of respiratory syncytial virus B infections among adult hematologic patients

Baier

Huang

Reumann

et al. 2022

Antimicrob Resist Infect Control

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Background Respiratory syncytial virus (RSV) causes community-acquired respiratory tract infections during winter. However, outbreaks in hospitals also occur repeatedly. In particular, patients with hematologic malignancies are at an increased risk for a severe and potentially fatal course of RSV infection. Here we present the investigation of an RSV outbreak in a hematology ward for adults following the ORION statement. Methods An epidemiologic and molecular outbreak analysis was performed. We developed and employed a minimal oligonucleotide probe set in target capture probe sequencing that allows cost-effective RSV-A or -B capturing to reconstruct RSV genomes from clinical samples. Results Four adult patients were involved in the outbreak caused by RSV-B in March 2019. The enforcement of the pre-existing infection control measures by effective training of hospital staff contributed to a successful containment. PCR-based RSV screening on the ward enabled early detection of new cases and rapid isolation measures. The molecular analysis demonstrated that the outbreak sequences were highly related and distinct to other RSV-B strains circulating at the same time. Conclusions A multimodal infection control concept is essential for the timely detection and control of RSV outbreaks in patients with hematological disease. Among other measures, preventive screening for respiratory viruses is recommended. Furthermore, the integration of conventional and molecular epidemiology, such as whole-genome sequencing and variant calling, significantly contributes to the understanding of transmission pathways. Based on this, appropriate conclusions can be drawn for targeted prevention measures that have prepared us for the COVID-19 pandemic beyond the RSV approach described here.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Target capture sequencing reveals a monoclonal outbreak of respiratory syncytial virus B infections among adult hematologic patients

Baier

Huang

Reumann

et al. 2022

Antimicrob Resist Infect Control

Self Cite

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“…Outbreaks identified in long-term care facilities in the late 1970s and early 1980s first drew attention to RSV as a potential cause of serious respiratory disease in older adults [ 68 ]. More recently, RSV outbreaks have predominantly been reported among immunocompromised adults, particularly in patients residing in hematology or oncology wards [ 69 70 71 72 ].…”

Section: Rsv Transmission Among High-risk Patientsmentioning

confidence: 99%

Epidemiology and Disease Burden of Respiratory Syncytial Virus Infection in Adults

Kim,

Choi

2024

Infect Chemother

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Respiratory syncytial virus (RSV) constitutes a significant cause of respiratory illness and mortality among older adults, a demographic that is expanding with considerable impact on healthcare systems worldwide. The actual burden of RSV in this population may still be underestimated, owing to factors such as low awareness and suboptimal diagnostic sensitivity in adults, the lack of robust RSV surveillance systems, and the infrequent use of diagnostic testing. Recent advancements in respiratory virus detection have spurred further exploration into appropriate preventive and therapeutic strategies. The recent approval of two vaccines highlights the critical need for the precise estimation of the RSV disease burden to optimize the effectiveness and cost-efficiency of immunization programs. This narrative review aimed to summarize the existing knowledge of the RSV burden in adults with a particular focus on older adults, incorporating data from Korea. Overall, current estimates indicate that the annual RSV attack rate in the general adult population ranges from 1 - 7%, increasing to approximately 4 - 10% among elderly and high-risk groups. The in-hospital mortality rate can be estimated to be around 7 - 10%, rising up to 40% among intensive care unit-admitted patients. To elucidate RSV’s disease burden, further continuing research, including population-based studies, is necessary.

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“… Particularly in the winter months (November to April; influenza and RSV season), in addition to prompt diagnostic tests for symptomatic patients, considering screening patients in risk group 3 (see Table 1 (Tab. 1) ) for influenza and RSV on admission, for example with (RT-)PCR tests, because this makes it easier to identify immunocompromised patients who are already infectious but not (yet) symptomatic and has many implications for individual patients and hospital hygiene [ 100 ], [ 101 ], [ 102 ], [ 103 ], [ 104 ], [ 112 ], [ 374 ], [ 375 ], [ 376 ], [ 377 ], [ 378 ], [ 379 ] (cat. II).…”

Section: Recommendationsmentioning

confidence: 99%

Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute

2022

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In Germany, guidelines for hygiene in hospitals are given in form of recommendations by the Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, “KRINKO”). The KRINKO and its voluntary work are legitimized by the mandate according to § 23 of the Infection Protection Act (Infektionsschutzgesetz, “IfSG”). The original German version of this document was published in February 2021 and has now been made available to the international professional public in English. The guideline provides recommendations on infection prevention and control for immunocompromised individuals in health care facilities. This recommendation addresses not only measures related to direct medical care of immunocompromised patients, but also management aspects such as surveillance, screening, antibiotic stewardship, and technical/structural aspects such as patient rooms, air quality, and special measures during renovations.

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Influenza and respiratory syncytial virus screening for the detection of asymptomatically infected patients in hematology and oncology

Cited by 9 publications

References 26 publications

Target capture sequencing reveals a monoclonal outbreak of respiratory syncytial virus B infections among adult hematologic patients

Target capture sequencing reveals a monoclonal outbreak of respiratory syncytial virus B infections among adult hematologic patients

Epidemiology and Disease Burden of Respiratory Syncytial Virus Infection in Adults

Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute

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