What are the isolation and treatment guidelines for Respiratory Syncytial Virus (RSV) infection?

RSV Isolation Guidelines

Patients with confirmed or suspected RSV infection require contact isolation precautions, including strict hand hygiene, glove and gown use, and ideally placement in private rooms or cohorting with other RSV-positive patients. 1, 2

Core Isolation Precautions

Hand Hygiene (Most Critical Measure)

• Perform hand hygiene before and after every patient contact, after touching any items in the patient's vicinity, and after removing gloves 1, 2, 3
• Use alcohol-based hand rubs when hands are not visibly soiled 2, 3
• Wash with antimicrobial soap when hands are visibly contaminated 2
• Hand hygiene is the single most important strategy for preventing RSV transmission in healthcare settings 3, 4

Personal Protective Equipment

• Wear gloves when entering the room of any patient with confirmed or suspected RSV infection and when handling respiratory secretions or contaminated fomites 1, 2
• Change gloves between different patients and after handling respiratory secretions before touching another patient 1
• Wear a gown when entering the room if contact with respiratory secretions is anticipated or when handling infants with RSV 1, 2
• Change gowns after contact with the patient and before caring for another patient 1
• Wear surgical mask and eye protection when performing procedures that might generate respiratory secretion sprays 2

Patient Placement and Cohorting

• Place RSV-positive patients in private rooms whenever possible 1, 2, 3
• If private rooms are unavailable, cohort RSV-positive patients together (separate from uninfected patients) 1, 2
• Perform rapid RSV diagnostic testing at admission during peak season (December-March) to facilitate appropriate cohorting 1
• Limit patient movement and transport to essential purposes only 2

Outbreak Control Measures

During Active RSV Outbreaks

• Cohort healthcare personnel—restrict staff caring for RSV-positive patients from caring for uninfected patients 1, 2
• Postpone elective admissions of high-risk uninfected patients (premature infants, immunocompromised, cardiac patients) 1
• Perform RSV screening on all young children with respiratory symptoms at admission 1

Healthcare Worker Restrictions

• Restrict healthcare workers with acute upper respiratory symptoms (sneezing, coughing) from caring for high-risk patients 1, 2
• High-risk patients include: premature infants, children with cardiopulmonary disease, children receiving chemotherapy, and immunocompromised patients 1

Visitor Restrictions

• Do not allow persons with respiratory infection symptoms to visit pediatric, immunosuppressed, or cardiac patients 1, 2

Surveillance and Education

Active Surveillance

• Establish mechanisms to promptly alert hospital personnel of increased RSV activity in the local community 1
• Use rapid diagnostic techniques (immunofluorescence, ELISA) for pediatric patients and immunocompromised adults with respiratory illness during RSV season 1

Staff Education

• Educate all healthcare personnel about RSV epidemiology, transmission modes, and prevention strategies 1, 3
• Train family members on hand hygiene and infection control measures 2, 3

Common Pitfalls to Avoid

• Delayed isolation of suspected RSV cases leads to nosocomial spread—implement contact precautions immediately upon suspicion, before diagnostic confirmation 2
• Inadequate hand hygiene is the most common transmission route in healthcare settings—enforce strict compliance with hand hygiene protocols 2, 3
• Failure to cohort patients and staff during outbreaks allows continued transmission 1, 2
• Allowing symptomatic visitors or healthcare workers near high-risk patients increases transmission risk 1, 2