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Respiratory Viral RNA on Toys in Pediatric Office Waiting Rooms

Pappas, Diane E. MD, JD*; Hendley, J Owen MD*; Schwartz, Richard H. MD

The Pediatric Infectious Disease Journal: February 2010 - Volume 29 - Issue 2 - p 102-104
doi: 10.1097/INF.0b013e3181b6e482
Original Studies

Background: Toys in pediatric office waiting rooms may be fomites for transmission of viruses.

Methods: Eighteen samples were taken from office objects on 3 occasions. Samples were tested for presence of picornavirus (either rhinovirus or enterovirus) on all 3 sample days; in addition, January samples were tested for respiratory syncytial virus and March samples were tested for influenza A and B. In addition, 15 samples were obtained from the sick waiting room before and after cleaning. Polymerase chain reaction was used to detect picornavirus, respiratory syncytial virus, and influenza A or B virus. Finally, 20 samples were obtained from the fingers of a researcher after handling different toys in the sick waiting room, and samples were then obtained from all the same toys; all samples were tested for picornavirus by polymerase chain reaction.

Results: Viral RNA was detected on 11 of 52 (21%) of toys sampled. Ten of the positives were picornavirus; 1 was influenza B virus. Three (30%) of 10 toys from the new toy bag, 6 of 30 (20%) in the sick child waiting room, and 2 of 12 (17%) in the well child waiting room were positive. Six (40%) of 15 toys in the sick waiting room were positive for picornaviral RNA before cleaning; after cleaning, 4 (27%) of 15 were positive in spite of the fact that RNA was removed from 4 of 6 of the original positives. Three (15%) of 20 toys in the sick waiting room were positive for picornaviral RNA, but RNA was not transferred to the fingers of the investigator who handled these toys.

Comment: About 20% of the objects in a pediatric office may be contaminated with respiratory viral RNA, most commonly picornavirus RNA. Cleaning with a disinfectant cloth was only modestly effective in removing the viral RNA from the surfaces of toys, but transfer of picornaviral RNA from toys to fingers was inefficient.

From the *Department of Pediatrics, University of Virginia Health System, Charlottesville, VA; and †INOVA Health Systems, Fairfax, VA.

Accepted for publication July 10, 2009.

Supported by the Pendleton Pediatric Infectious Laboratory at the University of Virginia.

Address for correspondence: Diane E. Pappas, MD, JD, University of Virginia Health System, Department of Pediatrics, P O Box 800386, Charlottesville, VA 22908. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.