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Detection, Control, and Management of a Respiratory Syncytial Virus Outbreak in a Pediatric Hematology-Oncology Department

Shachor-Meyouhas, Yael MD; Zaidman, Irina MD, PhD; Kra-Oz, Zipi PhD; Arad-Cohen, Nira MD; Kassis, Imad MD

Journal of Pediatric Hematology/Oncology: March 2013 - Volume 35 - Issue 2 - p 124–128
doi: 10.1097/MPH.0b013e3182756edc
Original Articles

Background: Immunocompromised patients are at increased risk for severe respiratory syncytial virus (RSV) infection. Palivizumab is approved for prevention of RSV in specific populations but not for treatment. Few studies demonstrated the safety and successful treatment with intravenous (IV) palivizumab. We describe our experience with IV palivizumab treatment for RSV in a pediatric hematology-oncology department during an outbreak.

Methods: During a short period of renovations, oncology patients were placed in a general pediatric ward. After a case of severe fatal RSV pneumonia in a 2-year-old male patient with acute myeloid leukemia, all patients were actively screened twice weekly regardless of symptoms. Respiratory samples were tested for RSV using rapid immunochromatography detection, immunofluorescence, or reverse transcriptase polymerase chain reaction. A single dose of palivizumab (15 mg/kg) was given to children below 3 years of age who tested positive for RSV.

Results: Over a 6-week period, 12 patients tested positive for RSV. Seven patients were treated with palivizumab. Five patients had respiratory symptoms, and 2 were asymptomatic. No adverse events were attributed to IV palivizumab treatment. Early-treated patients had no complications attributed to RSV.

Conclusions: Containment of RSV outbreak in high-risk children is difficult. Screening with reverse transcriptase polymerase chain reaction and the early use of IV palivizumab is safe and may prevent complications of RSV infection among these patients.

*Pediatric Infectious Disease Unit

Department of Pediatric Hematology-Oncology

Virology Laboratory, Meyer Children’s Hospital, Rambam Health Care Campus, Haifa, Israel

The authors declare no conflict of interest.

Reprints: Yael Shachor-Meyouhas, MD, Infectious Diseases Unit, Meyer Children’s Hospital, Rambam Health Care Campus, P.O. Box 9602, Haifa 31096, Israel (e-mail:

Received September 23, 2011

Accepted June 26, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.