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Biol Blood Marrow Transplant. 2014 Jun;20(6):844-51. doi: 10.1016/j.bbmt.2014.02.024. Epub 2014 Mar 6.

Nosocomial transmission of respiratory syncytial virus in an outpatient cancer center.

Author information

1
Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington. Electronic address: helenchu@uw.edu.
2
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Pediatrics, Section of Infectious Diseases, Seattle Children's Hospital, University of Washington, Seattle, Washington.
3
Infection Control and Prevention Program, Seattle Cancer Care Alliance, Seattle, Washington.
4
Department of Laboratory Medicine, University of Washington, Seattle, Washington.
5
Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Public Health Sciences Divisions, Fred Hutchinson Cancer Research Center, Seattle, Washington.
6
Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Infection Control and Prevention Program, Seattle Cancer Care Alliance, Seattle, Washington; Public Health Sciences Divisions, Fred Hutchinson Cancer Research Center, Seattle, Washington.

Abstract

Respiratory syncytial virus (RSV) outbreaks in inpatient settings are associated with poor outcomes in cancer patients. The use of molecular epidemiology to document RSV transmission in the outpatient setting has not been well described. We performed a retrospective cohort study of 2 nosocomial outbreaks of RSV at the Seattle Cancer Care Alliance. Subjects included patients seen at the Seattle Cancer Care Alliance with RSV detected in 2 outbreaks in 2007-2008 and 2012 and all employees with respiratory viruses detected in the 2007-2008 outbreak. A subset of samples was sequenced using semi-nested PCR targeting the RSV attachment glycoprotein coding region. Fifty-one cases of RSV were identified in 2007-2008. Clustering of identical viral strains was detected in 10 of 15 patients (67%) with RSV sequenced from 2007 to 2008. As part of a multimodal infection control strategy implemented as a response to the outbreak, symptomatic employees had nasal washes collected. Of 254 employee samples, 91 (34%) tested positive for a respiratory virus, including 14 with RSV. In another RSV outbreak in 2012, 24 cases of RSV were identified; 9 of 10 patients (90%) had the same viral strain, and 1 (10%) had another viral strain. We document spread of clonal strains within an outpatient cancer care setting. Infection control interventions should be implemented in outpatient, as well as inpatient, settings to reduce person-to-person transmission and limit progression of RSV outbreaks.

KEYWORDS:

Health care worker; Infection control; Molecular epidemiology; Outpatient clinic; Respiratory syncytial virus

PMID:
24607551
PMCID:
PMC4036533
DOI:
10.1016/j.bbmt.2014.02.024
[Indexed for MEDLINE]
Free PMC Article

Publication type, MeSH terms, Grant support

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