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Serious Respiratory Virus Brought Into NICU by Clothing of Visitors, Caregivers

ATLANTA – As diligent as you are about hand washing, you and your colleagues might still be bringing respiratory syncytial virus (RSV) into the neonatal intensive care unit at your hospital.

That’s according to a presentation at the recent International Conference on Emerging and Infectious Diseases in Atlanta which reported that RSV, the leading cause of childhood respiratory hospitalizations among premature babies, can be detected from the clothes worn by caregivers/visitors visiting the NICU.

The Australian study was led by researchers from the University of New South Wales.

"The aim of this study was to identify potential sources of transmission of RSV in the NICU to better inform infection control strategies," said UNSW researcher Nusrat Homaira, PhD.

For the study conducted in May and June 2014, researchers collected specimens once every week from the hands, nose and the clothes of physicians, nurses and visitors to the NICU at the Royal Hospital for Women in Sydney. A nasal swab specimen was also collected from the infants admitted.

Detectable RSV was found in 4% of the swabs collected from the personal clothing of caregivers/visitors, and the virus also was detected from 9% of the high-touch areas in the NICU, including computers on the nurse's table, chairs adjacent to the infant patients and their bed rails.

"Though the detection rate is low, personal clothing of caregivers/visitors do get contaminated with RSV,” Homaira said in an American Society for Microbiology press release.

Although caregivers/visitors are not required to change clothing when they walk into the NICU at that hospital, "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," she added.

Interestingly, RSV was not detectable in the hands of the doctors, nurses or the visitors with readily available alcohol-based hand rub and good hand hygiene practices overall.

The study authors conclude that frequent cleaning of high touch areas and periodic screening of visitors for RSV as they enter into the NICU during period of annual seasonal epidemics might help to limit transmission of the disease, adding, “Although detection of RSV was infrequent, the intimate contact between preterm neonates and visitors means personal clothing may play a role in RSV transmission."