Palivizumab Effectiveness in Controlling Respiratory Syncytial Virus Outbreak

Strategic Insights -

A severe respiratory syncytial virus (RSV) outbreak occurred in a large neonatal intensive care unit (NICU) in Portugal between November 1998 and March 1999. Retrospective analysis of the outbreak and the use of palivizumab, a humanized RSV monoclonal antibody, revealed that standard infection control measures were effective in the first outbreak but not in the second. The introduction of palivizumab in the second outbreak led to a significant decrease in the cumulative incidence and secondary attack rate of RSV infection. The study suggests that palivizumab could be a valuable additional resource in controlling severe nosocomial RSV outbreaks.

Key Takeaways:

  • The study analyzed two RSV outbreaks in a NICU in Portugal, with the first outbreak occurring between November 1998 and March 1999.
  • Standard infection control measures were effective in the first outbreak, but not in the second, which resulted in five additional infants being newly RSV-infected within one month.
  • The cumulative incidence of RSV infection was 2.4% in the first 15 days and 10.5% in the second among all infants, and 2.9 parts per thousand in the first 15 days and 14.1 parts per thousand in the second among infants under 32 weeks gestational age.
  • The introduction of palivizumab in the second outbreak led to a significant decrease in the cumulative incidence and secondary attack rate of RSV infection, dropping to zero after administration.
  • The risk ratio of infection was 4.65 times higher in infants under 32 weeks gestational age.
  • The use of palivizumab might have contributed to arresting the outbreak of RSV infection in the NICU.

Statistics:

  • 3 cases among 26 beds in the first outbreak
  • 5 additional infants were newly RSV-infected within one month in the second outbreak
  • 2.4% cumulative incidence in the first 15 days of the second outbreak
  • 10.5% cumulative incidence in the second 15 days of the second outbreak
  • 2.9 parts per thousand secondary attack rate in the first 15 days of the second outbreak
  • 14.1 parts per thousand secondary attack rate in the second 15 days of the second outbreak
  • Risk ratio of infection: 4.65 times higher in infants under 32 weeks gestational age

Sources:

  • Abadesso, C., et al. (2004) "Use of palivizumab to control an outbreak of syncytial respiratory virus in a neonatal intensive care unit." Journal of Hospital Infection, 58(1), 38-41.
  • NewsRx.com & NewsRx.net. (2004 DEC 13) "Palivizumab was used to control a respiratory syncytial virus outbreak in a neonatal intensive care unit."