ATLANTA – Clothing worn by caregivers and visitors may be an important vehicle for the transmission of respiratory syncytial virus in the neonatal intensive care unit setting, according to findings from a prospective study conducted in an Australian hospital.
In an effort to identify potential sources of RSV transmission and to facilitate development of infection control strategies, the investigators swabbed all health personnel, every third neonate and their visitors, and any child clinically suspected of having an RSV infection. They detected RSV in one of 81 nasal specimens collected from 55 neonates and in 4% of 80 visitors’ clothing swabs, Nusrat Homaira, Ph.D., of the University of New South Wales, Sydney, and her colleagues reported in a poster at the International Conference on Emerging Infectious Diseases.
©Dr. Craig Lyerla / CDC
RSV also was detected in 1% of nose swabs from the visitors and in 1% of nose swabs from 84 health care workers.
No RSV was detected on the clothing of health care workers or on the hands of visitors or health care workers, which may be explained by the presence of alcohol-based hand rub at the point of care and by prevalent hand hygiene practices within the neonatal intensive care unit (NICU), the investigators noted.
The investigators also collected environmental swabs and detected RSV on 9% of high-touch areas, including bed rails; chairs; bed surfaces; countertops; and nurse’s and doctor’s station tables, computers, and chairs.
Samples were collected once each week for 8 weeks during May and June of 2014.
RSV is a major cause of morbidity in very young children, and premature infants have a 10-fold increase in the risk of acquiring RSV infection. Hospital-acquired cases are an important cause of prolonged hospitalization, Dr. Homaira and her associates noted.
The findings suggest that personal clothing may be one of the modes of virus transmission, they said.
“Though the detection rate is low, personal clothing of caregivers/visitors do get contaminated with RSV,” Dr. Homaira said in a written statement, noting that caregivers and visitors are not required to change clothing when they walk into the NICU.
“There is a need for further research to evaluate how long the virus remains infectious on personal clothing, which will have policy implications in terms of need for use of separate gowns by the visitors while they are in the NICU,” Dr. Homaira added, concluding that frequent cleaning of high-touch areas and periodic screening of visitors for RSV as they enter the NICU during seasonal epidemics also may help limit disease transmission.
The investigators reported having no disclosures.