Reducing the rate of nosocomially transmitted respiratory syncytial virus

Background: A large number (17) of nosocomial respiratory syncytial virus c ases led to the development of control measures to prevent transmission of respiratory syncytial virus (RSV) within the Johns Hopkins Hospital's Child ren's Center. Methods: The control plan is based on a 2-stage process. In stage 1, the st aff are notified that RSV is in the community, and information is distribut ed through a communication tree. Stage 2 requires that nasopharyngeal aspir ates be obtained from all children <3 years of age who have respiratory sym ptoms. The aspirates are tested directly for RSV antigen and cultured for R SV. The children are placed on pediatric droplet precautions pending those results. Results: The proportion of nosocomial RSV cases dropped from 16.5% before t he use of RSV control measures to 7.2% after the initiation of the control program. A case of RSV identified in the hospital was 2.6 times more likely to be nosocomially acquired before the intervention compared with after th e intervention. Approximately 14 cases of RSV are prevented each year, whic h results in a savings of 56 hospital-days and more than $84,000 in direct hospital-related charges alone. Conclusions: The nosocomial spread of RSV can be reduced by a specific and feasible control plan that includes early identification and rapid isolatio n of potential RSV cases.