RSV Outbreak at a Single Postpartum Care Center in Gyeongsangbukdo

Seung Jee Hong; Doo Kwun Kim; Dong Seok Lee; Seung Man Cho; Sung Min Choi

doi:10.14734/kjp.2016.27.1.60

Journal List > Korean J Perinatol > v.27(1) > 1013798

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Hong, Kim, Lee, Cho, and Choi: RSV Outbreak at a Single Postpartum Care Center in Gyeongsangbukdo

Original Article

Korean J Perinatol 2016;27(1):60-66.

Published online: 19 March 2016

DOI: https://doi.org/10.14734/kjp.2016.27.1.60

RSV Outbreak at a Single Postpartum Care Center in Gyeongsangbukdo

Seung Jee Hong, M.D., Doo Kwun Kim, M.D., Dong Seok Lee, M.D., Seung Man Cho, M.D., Sung Min Choi, M.D., Ph.D.

Department of Pediatrics, Dongguk University College of Medicine, Gyeongju, Korea

Correspondence to: Sung Min Choi, M.D., Ph.D. Department of Pediatrics, Dongguk University Gyeongju Hospital, 87 Dongdae-ro, Gyeongju, Kyeongbuk 780-350, Korea Tel: +82-54-770-8252, Fax: +82-54-770-8500 E-mail: csm21@dongguk.ac.kr

Received 10 December 2015 Revised 3 March 2016 Accepted 3 March 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

We performed an analysis of the RSV outbreak in a postpartum center in Gyeongsangbukdo to provide preliminary data for health and hygiene management of postpartum care centers.

Methods:

All of 22 newborns who were transferred to our hospital from a postpartum care center from December 2014 to January 2015 showed positive for RSV by viral culture and enrolled in the study group. To identify early symptoms in RSV infected newborn in the nursery 31 infants (1 month to 24 month of age) who were hospitalized in our hospital due to RSV infection during the same period were selected as control group and clinical symptoms were compared with the study group. A retrospective study was also performed on the newborns who were cared and not transferred to our hospital in the postpartum care center, as well as the facilities offered by the center.

Results:

All of 22 neonatal patients who were transferred to our hospital had early symptoms of rhinorrhea and cough compared to control group. Rhinorrhea appeared 4.2±2.0 days before the admission, and cough occurred 1.0±1.1 days after rhinorrhea. The level of infection control specified by the law for general facilities relating to postpartum care centers was applied to the postpartum center, RSV infection was not controlled. Strict hand washing, individual equipment such as stethoscopes and exclusion of visitors with respiratory symptoms were done and infected neonates were segregated in separate air circulation system and cared by nurse-infant ratios from 1:1 to 1:2 depending on the needs of the individual neonates. Additional transmission was not observed after transfer to our hospital

Conclusion:

Neonates with cough and rhinorrhea were initial symptom for RSV infection in the postpartum center and should be evaluated for RSV infection during high risk season. Current guideline or support for infection control in postpartum center should be reevaluated for RSV infection control.

Keywords: Neonates, Respiratory syncytial virus, Outbreaks

REFERENCES

1). Ahn JG., Choi SY., Kim DS., Kim KH. A Nationwide survey on the child day care and common infectious diseases. Korean J Pediatr Infect Dis. 2012. 19:19–27.

2). Stensballe LG., Devasundaram JK., Simoes EA. Respiratory syncytial virus epidemics the ups and downs of a seasonal virus. Pediatr Infect Dis J. 2003. 22:21–32.

3). Hall CB. Nosocomial respiratory syncytial virus infections: the “cold war” has not ended. Clin Infect Dis. 2000. 31:590–6.

4). Department of Health and Human Services. Infection control guidelines for postpartum care centers. Seoul: The Department;2013.

5). Fair Trade Commission. Consumer report: Illness, injury occurred in postpartum care center. Fair Trade Commission 2014 Nov.

6). Yoo EK. Development of wise sanhujori guideline. Seoul: National Health Report;2013. Contact No.: Jung Chack 13-32. Sponsored by the Korea Institute of Child Care and Education.

7). Garcia CG., Bhore R., Soriano-Fallas A., Trost M., Chason R., Ramilo O, et al. Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis. Pediatrics. 2010. 126:e1453–60.

8). Eem YJ., Bae EY., Lee JH., Jeong DC. Risk factors associated with respiratory virus detection in infants younger than 90 days of age. Korean J Pediatr Infect Dis. 2014. 21:22–8.

9). Hacimustagaoglu M., Celebi S., Bozdemir SE., Ozgur T., Ozcan I., Guray A, et al. RSV frequency in children below 2 years hospitalized for lower respiratory tract infections. Turkish J Pediatr. 2013. 55:130–9.

10). Hall CB. Nosocomial viral respiratory infections: perennial weeds on pediatric wards. Am J Med. 1981. 70:670–6.

11). Nagayama Y., Tsubaki T., Nakayama S., Sawada K., Taguchi K., Tateno N, et al. Gender analysis in acute bronchiolitis due to respiratory syncytial virus. Pediatr Allergy Immunol. 2006. 17:29–36.

12). Cho JI., Choi HC., Kim JD., Cho JH. The clinical study of the lower respiratory tract infection by respiratory syncytial virus on children under 2 year of age. Pediatr Infect Dis J. 2000. 7:193–200.

13). Lim IS., Shim Mj., Kim BE., Chung JY., Kim CK., Chey MJ, et al. A comparison of clinical manifestations in neonates and infants infected by respiratory syncytial virus. Korean J Pediatr. 2004. 47:949–52.

14). Hall CB., Douglas RG Jr., Geiman JM. Respiratory syncytial virus infections in infants: quantitation and duration of shedding. J Pediatr. 1976. 89:11–5.

15). Shay DK., Holman RC., Roosevelt GE., Clarke MJ., Anderson LJ. Bronchiolitis-associated mortality and estimates of respiratory syncytial virus-associated deaths among US children 1979-1997. J Infect Dis. 2001. 183:16–22.

16). Halasa NB., Williams JV., Wilson GJ., Walsh WF., Schaffner W., Wright PF. Medical and economic impact of a respiratory syncytial virus outbreak in a neonatal intensive care unit. Pediatr Infect Dis J. 2005. 24:1040–1044.

17). Siegel JD., Rhinehart E., Jackson M., Chiarello L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. Am J Infect Control. 2007. 35(10 Suppl 2):S65–164.

Fig. 1

Weekly distribution of Respiratory Syncytial Virus infections. The horizontal (x) axis represents the weeks of December and January for Respiratory Syncytial Virus infected newborn (black bars) and infant (gray dashed bars); the vertical axis displays total number of cases identified per weeks during the study period.

Table 1.

Demographic Characteristics of Respiratory Syncytial Virus Positive Group and Respiratory Syncytial Virus Negative Group of Neonates at a Postpartum Care Center

Characteristics	Total n=76 (%)	Total patients (n=74)
Characteristics	Total n=76 (%)	RSV positive n=24 (%)^†	RSV negative n=52 (%)	P-value
Gender : Male	44 (57.9)	13 (54.2)	31 (59.6)	0.66
Gestational age (wks)∗	38.1±1.0	38.5±1.2	38.1±0.8	0.17
Birth weight (kg)∗	3.2±0.4	3.1±0.5	3.3±0.4	0.029
Delivery method : NVD	52 (68.4)	13 (54.2)	39 (75)	0.09
Rooming in	3 (3.9)	0	3 (5.8)	0.083

∗Expressed as mean±SD.

^† two nates were transferred to other hospitals and excluded from the further study. Abbreviations: RSV, Respiratory syncytial virus; NVD, normal vaginal delivery.

Table 2.

Comparison of Clinical Characteristics between Neonates and Infants with Respiratory Syncytial Virus infection

	Under 28 days n=22 (%)	Between 28 days and 24 months n=31 (%)	P-value	OR (95%CI)
Age	16.3±4.8 days	7.5±2.4 months	-∗	-
Gender : Male	13 (59.1)	19 (61.3)	0.872	1.096 (0.359-3.345)
Cough	22 (100)	31 (100)	-	-
Rhinorrhea	22 (100)	31 (100)	-	-
Fever	2 (9.0)	14 (45.2)	0.005	8.235 (1.635-41.469)
Poor oral intake	12 (54.5)	8 (25.8)	0.033	0.290 (0.091-0.927)
Cyanosis	4 (18.2)	0 (0)	0.025^†	-∗
Tachypnea	10 (45.5)	7 (22.6)	0.079	0.350 (0.107-1.149)
Chest retraction	6 (27.3)	3 (9.7)	0.140^†	0.286 (0.063-1.301)
Wheezing	7 (31.8)	14 (45.2)	0.328	1.765 (0.563-5.531)
Rale	15 (68.2)	17 (54.8)	0.328	0.567 (0.181-1.776)
Hospital days	7.7±2.4	6.2±3.5	0.058	-

∗Not available

^† Use fisher's exact test for expect cell sizes less than 5. Abbreviations: OR, odds ratio; 95%CI, 95% confidence interval.

TOOLS

Similar articles