THE CLINICAL PICTURE PRESENTED BY PREMATURE NEONATES INFECTED WITH THE RESPIRATORY SYNCYTIAL VIRUS

During the course of a 3-year epidemic of respiratory syncytial virus (RSV) in an Neonatal Intensive Care Unit, we examined premature neonat es for the clinical features of RSV infections and the risk factors pr edisposing towards transmission of the disease. Seventy-nine infants w ith a median gestational age of 31 weeks were tested in 113 episodes o f clinical deterioration for the presence of RSV antigen in nasopharyn geal secretions. Forty-seven results were positive and 66 negative. Br adycardia, which is gestational-age dependent, was the main presenting clinical symptom of an RSV infection in 75% of cases. The probability of an RSV-positive result in an episode with bradycardia, hypercapnia and fever was calculated to be 0.75. The only identifiable epidemiolo gical risk factor was the total number of symptomatic RSV-infected inf ants in the ward. Conclusion Bradycardia may indicate the presence of an RSV infection: the appropriate tests should be carried out and infe ction control reinforced immediately.