Abstract
During the course of a 3-year epidemic of respiratory syncytial virus (RSV) in an Neonatal Intensive Care Unit, we examined premature neonates for the clinical features of RSV infections and the risk factors predisposing towards transmission of the disease. Seventy-nine infants with a median gestational age of 31 weeks were tested in 113 episodes of clinical deterioration for the presence of RSV antigen in nasopharyngeal secretions. Forty-seven results were positive and 66 negative. Bradycardia, 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 epidemiological risk factor was the total number of symptomatic RSV-infected infants in the ward.
Conclusion
Bradycardia may indicate the presence of an RSV infection: the appropriate tests should be carried out and infection control reinforced immediately.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
Abbreviations
- (N) NA :
-
(non) nosocomial affected
- NICU :
-
neonatal intensive care unit
- RSV :
-
respiratory syncytial virus
References
Amir J, Wielunsky E, Zelikovic I, Varsano N, Rannon L, Reisner SH (1984) Outbrak of respiratory syncytial virus infection in an neonatal intensive care unit. Isr J Med Sci 20: 1199–1201
Anas N, Boettrich C, Hall CB, Brooks JC (1982) The association of apnoea and respiratory syncytial virus infection in infants J Pediatr 101:65–68
Berkovich S, Taranko L (1964) Acute respiratory illness in the premature nursery associated with respiratory syncytial virus infections. Pediatrics 34:753–760
Breton A, Samaille J, Gaudier B et al. (1961) Isolement du virus syncytial (virus C.C.A. de Morris) au cours de manifestations respiratoires benignes épidémiques chez des prématures. Arch Fr Pediatr 18:459–467
Bruhn FW, Mokrohisky, ST, McIntosh K (1977) Apnoea associated with respiratory syncytial virus infection in young infants. J Pediatr 90:382–386
Chanock R, Finberg L (1957) Recovery from infants with respiratory illness of a virus related to chimpanzee coryza agent (CCA). II. Epidemiologic aspects of infection in infants and young children. Am J Hyg 66:291–300
Chanock R, Roizman B, Myers R (1957) Recovery from infants with respiratory illness of a virus related to chimpanzee coryza agent (CCA). I. Isolation, properties and characterization. Am J Hyg 66:281–290
Church NR, Anas NG, Hall CB, Brooks JG (1984) Respiratory syncytial virus-related apnoea in infants. Demographics and outcome. Am J Dis Child 138:247–250
Committee on Infectious Diseases (1991) Report of the committee on infectious diseases, 22nd edn. American Academy of Pediatrics p 581–587
Gala CL, Hall CB, Schnabel KC, Pincus PH, Blossom P, Hildreth SW, Betts RF, Douglas G (1986) The use of eyenose goggles to control nosocomial respiratory syncytial virus infection. J Am Med Ass 256:2706–2708
Gouyon JB, Fantino M, Couillault G, Durand C, Pothier R, Alison M (1986) Infections à virus respiratoire syncytial du nouveau-né. Arch Fr Pediatr 42: 93–97
Hall CB (1982) Respiratory syncytial virus: Its transmission in the hospital environment. Yale J Biol Med 55: 219–223
Hall CB, Kopelman AE, Douglas RG, Geiman JM, Meagher MP (1979) Neonatal respiratory syncytial virus infection. N Engl J Med 300:393–396
Hornsleth A, Friis B, Andersen P, Brenoe E (1982) Detection of respiratory syncytial virus in nasopharyngeal secretions by ELISA, comparison with fluorescent antibody technique. J Med Virol 10:273–281
La Via WV, Grant SW, Stuttman HR, Marks MI (1993) Clinical profile of pediatric patients hospitalized with respiratory syncytial virus infection. Clin Pediatr 450–454
Leclair JM, Freeman J, Sullivan BF, Crowley CM, Goldman DA (1987) Prevention of nosocomial respiratory syncytial virus infections through compliance with glove and gown isolation precautions. N Engl J Med 317: 329–334
Meert K, Heidemann S, Abella B, Sarnaik A (1990) Does prematurity alter the course of respiratory syncytial virus infection? Crit Care Med 18:1357–1359
Meissner HC, Murray SA, Kierman MA, Snydman DR, McIntosh K (1984) A simultaneous outbrek of respiratory syncytial virus and parainfluenza virus type 3 in a newborn nursery. J Pediatr 104:680–684
Meurman O, Sarkkinnen H, Ruskanen O, Hanningen P, Halonen P (1984) Diagnosis of respiratory syncytial virus infection in children: comparison of viral antigen detection and serology. J Med Virol 14:61–65
Njoku DB, Kliegman RM (1993) Atypical extrapulmonary presentation of severe respiratory syncytial virus infection requiring intensive care. Clin Pediatr 455–460
Pickens DL, Schefft GL, Storch GA, Thach BT (1989) Characterization of prolonged apneic episodes associated with respiratory syncytial virus infection. Pediatr Pulmonol 6:195–201
Snydman DR, Greeg C, Meissner C, McIntosh K (1988) Prevention of nosocomial transmission of respiratory syncytial virus in a newborn nursery. Infect Control Hosp Epidemiol 9: 105–108
Steensel-Moll HA van, Tissing WJE, Offringa M, Hazelzet JA (1990) Mechanical ventilation and respiratory syncytial virus. Arch Dis Child 65:332
Steensel-Moll HA van, Voort E van der, Bos AP, Rothbarth PH, Neijens HJ (1989) Respiratory syncytial virus infection in children admitted to the intensive care unit. Pédiatrie 44:583–588
Stretton M, Ajizian SJ, Mitchel I, Newth CJL (1992) Intensive care course and outcome of patients infected with respiratory syncytial virus. Pediatr Pulmonol 13:143–150
Subbaro EK, Griffis J, Waner JL (1989) Detection of multiple viral agents in nasopharyngeal specimens yielding respiratory syncytial virus (RSV). An assessment of diagnostic strategy and clinical significance. Diagn Microbiol Infect Dis 12:327–332
Valenti WM, Clarke TA, Hall CB, Menegus MA, Shapiro DL (1982) Concurrent outbreaks of rhinovirus and respiratory syncytial virus in an intensive care nursery: Epidemiology and associated risk factors. J Pediatr 100: 722–726
Waris M, Meurman O, Mufson MA, Ruuskanen O, Halonen P (1992) Shedding of infectious virus and virus antigen during acute infection with respiratory syncytial virus. J Med Virol 38: 111–116
Wasburne JF, Bocchini JA, Jamison RM (1992) Summertime respiratory syncytial virus infection: epidemiology and clinical manifestation. South Med J 85:579–583
White MP, Mackie PLK (1990) Respiratory syncytial virus infection in special care nursery. Lancet 335:979
Wilson CW, Stevenson DK, Arvon AM (1989) A concurrent epidemic of respiratory syncytial virus and echovirus 7 infections in an intensive care nursery. Pediatr Infect Dis J 8: 24–29
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Forster, J., Schumacher, R.F. The clinical picture presented by premature neonates infected with the respiratory syncytial virus. Eur J Pediatr 154, 901–905 (1995). https://doi.org/10.1007/BF01957502
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01957502