Research In Practice Blog

Intro:

Respiratory syncytial virus, or RSV, is a very common illness in children. RSV causes cold-like symptoms, can sometimes cause lower respiratory infections, and can be severe in infants and health-compromised people. Outbreaks of healthcare-associated RSV (HA-RSV) pose known danger to hospitalized children, and the virus results in increased healthcare resource utilization. Therefore, most hospitals have implemented protocols to prevent such infectious situations. But, our researchers asked, what about sporadic HA-RSV—the occasional, irregular occurrence of RSV of a hospitalized child despite the absence of an outbreak?

Study design & findings:

Along with their colleagues, Clinical Futures’ Susan E. Coffin, MD, MPH, and Morgan Zalot Hammershaimb, MPH, conducted a multi-center study to learn more about the epidemiology of HA-RSV and examine the associated outcomes and respiratory support needs for affected children. Though the authors found that cases of sporadic HA-RSV were relatively rare, they also found that national surveillance protocols for identification and reporting are insufficient.

The authors found that the risk of HA-RSV is greater for older, medically complex children who often have prolonged hospitalizations and longer time at risk for HA-respiratory viral infections. Most children with HA-RSV infections and two or more comorbid conditions—most frequently cardiovascular, gastrointestinal, neurologic/neuromuscular, and respiratory comorbidities. They demonstrated that sporadic HA-RSV cases were temporally associated with increased morbidity, as some children required escalation of respiratory support and PICU-level care.

Implications:

The authors established a need for improved and standardized surveillance definitions and more consistent surveillance practices. They also suggest that there are quality improvement opportunities within hospital settings that could help preventing contract transmission (specifically noting that masks alone do not prevent RSV transmission).

NOTE: Newly approved RSV immunizations are available for older adults and infants; maternal vaccines are in development. Visit CDC for more information.

Study authors from Clinical Futures: Susan E. Coffin, MD, MPH and Morgan Zalot Hammershaimb, MPH

Saiman L, Coffin SE, Kociolek LK, et al. Healthcare-Associated Respiratory Syncytial Virus in Children's Hospitals. J Pediatric Infect Dis Soc. 2023;12(5):265-272. doi:10.1093/jpids/piad030