Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review

Respiratory syncytial virus (RSV) causes a significant public health burden, and outbreaks among vulnerable patients in hospital settings are of particular concern. We reviewed published and unpublished literature from hospital settings to assess: (i) nosocomial RSV transmission risk (attack rate) d...

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Bibliographic Details
Published in:Influenza and other respiratory viruses Vol. 10; no. 4; pp. 268 - 290
Main Authors: French, Clare E., McKenzie, Bruce C., Coope, Caroline, Rajanaidu, Subhadra, Paranthaman, Karthik, Pebody, Richard, Nguyen‐Van‐Tam, Jonathan S., Higgins, Julian P. T., Beck, Charles R.
Format: Journal Article
Language:English
Published: England John Wiley & Sons, Inc 01.07.2016
John Wiley and Sons Inc
Subjects:
Animals
Bias
Cross Infection - prevention & control
Cross Infection - transmission
Cross Infection - virology
Disease control
Disease prevention
Disinfection & disinfectants
English language
Epidemics
Eye protection
Hospitals
Humans
Hygiene
Immunoglobulins
Immunotherapy
Infection Control
Infections
Influenza
Intensive care
Libraries
Masks
Median (statistics)
Monoclonal antibodies
Neonates
Nosocomial infection
nosocomial infections
Nursing
Outbreaks
palivizumab
Patients
Personal protective equipment
Prophylaxis
Protective equipment
Public health
Questions
Respiratory diseases
Respiratory syncytial virus
Respiratory Syncytial Virus Infections - prevention & control
Respiratory Syncytial Virus Infections - transmission
Respiratory Syncytial Virus Infections - virology
Respiratory Syncytial Virus, Human - genetics
Respiratory Syncytial Virus, Human - physiology
Review
Studies
Systematic review
Viruses
Websites
nosocomial infections
personal protective equipment
palivizumab
respiratory syncytial virus
Infection control
ISSN:1750-2640, 1750-2659, 1750-2659
Online Access:Get full text
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Summary:Respiratory syncytial virus (RSV) causes a significant public health burden, and outbreaks among vulnerable patients in hospital settings are of particular concern. We reviewed published and unpublished literature from hospital settings to assess: (i) nosocomial RSV transmission risk (attack rate) during outbreaks, (ii) effectiveness of infection control measures. We searched the following databases: MEDLINE, EMBASE, CINAHL, Cochrane Library, together with key websites, journals and grey literature, to end of 2012. Risk of bias was assessed using the Cochrane risk of bias tool or Newcastle–Ottawa scale. A narrative synthesis was conducted. Forty studies were included (19 addressing research question one, 21 addressing question two). RSV transmission risk varied by hospital setting; 6–56% (median: 28·5%) in neonatal/paediatric settings (n = 14), 6–12% (median: 7%) in adult haematology and transplant units (n = 3), and 30–32% in other adult settings (n = 2). For question two, most studies (n = 13) employed multi‐component interventions (e.g. cohort nursing, personal protective equipment (PPE), isolation), and these were largely reported to be effective in reducing nosocomial transmission. Four studies examined staff PPE; eye protection appeared more effective than gowns and masks. One study reported on RSV prophylaxis for patients (RSV‐Ig/palivizumab); there was no statistical evidence of effectiveness although the sample size was small. Overall, risk of bias for included studies tended to be high. We conclude that RSV transmission risk varies widely during hospital outbreaks. Although multi‐component control strategies appear broadly successful, further research is required to disaggregate the effectiveness of individual components including the potential role of palivizumab prophylaxis.
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ISSN:1750-2640
1750-2659
1750-2659
DOI:10.1111/irv.12379