title: Detection, control, and management of a respiratory syncytial virus outbreak in a pediatric hematology-oncology department.
abstract: 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.
authors.affiliation: Department of Pediatric Hematology-Oncology, Meyer Children's Hospital, Haifa, Israel. y_shahor@rambam.health.gov.il
authors.forename: Yael
authors.initials: Y
authors.lastname: Shachor-Meyouhas
authors.forename: Irina
authors.initials: I
authors.lastname: Zaidman
authors.forename: Zipi
authors.initials: Z
authors.lastname: Kra-Oz
authors.forename: Nira
authors.initials: N
authors.lastname: Arad-Cohen
authors.forename: Imad
authors.initials: I
authors.lastname: Kassis
mesh_terms: D000293:Adolescent; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D007223:Infant; D000069455:Palivizumab; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000188:drug therapy
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab