COMMUNITY RESPIRATORY VIRUS-INFECTIONS AMONG HOSPITALIZED ADULT BONE-MARROW TRANSPLANT RECIPIENTS

From 1 November 1992 through 1 May 1993 and from 1 November 1993 throu gh 1 May 1994, we conducted a prospective surveillance study at the Un iversity of Texas M.D. Anderson Cancer Center (Houston) to evaluate th e role of community respiratory virus infections in hospitalized adult bone marrow transplant (BMT) recipients, Respiratory secretions were obtained from all adult BMT recipients with acute respiratory illnesse s. During these two winters, a community respiratory virus was isolate d from 37 (36%) of 102 patients and 30 (26%) of 115 patients, respecti vely. Approximately half (49%) of these infections were due to respira tory syncytial virus (RSV); the remainder were due to influenza virus (18%), picornaviruses (18%), parainfluenza virus (9%), or adenovirus ( 6%). Fifty-eight percent of these infections were complicated by pneum onia, with an associated mortality of 51%. The pneumonias that complic ated RSV infection were almost exclusively viral in origin and were as sociated with a mortality of 100% if not treated promptly with antivir al agents. In contrast, many of the pneumonias that complicated the ot her viral infections, such as influenza, appeared to be either self-li mited viral pneumonias or secondary bacterial or fungal pneumonias. Co mmunity respiratory viruses are frequent causes of acute respiratory i llnesses in adult BMT recipients hospitalized during the winter and ar e associated with substantial morbidity and mortality.