Impact of a respiratory syncytial virus outbreak in a tertiary care hospital neonatal intensive care unit

Abstract

Respiratory syncytial virus (RSV) is the major causes of respiratory tract infections during infancy, with high rates of hospitalization and mortality during the first year of life. RSV has been linked to recurrent wheezing and paediatric asthma. Infections are more severe in high-risk neonates, including those below six months of age, with prematurity, congenital heart diseases, neuromuscular disorders, or immune deficiencies. This prospective study was conducted at the out born NICU of Indira Gandhi institute of child health, a tertiary care centre in Bengaluru, between July 2018 and January 2019. Nasal turbinate samples were collected from 9 infants for RT-PCR testing irrespective of the mode of respiratory support. RSV-positive neonates were included for analysis. Of the 9 neonates, 7 (78%) were male and 2 (22%) females. Most were term babies (67%). All neonates were symptomatic with fever, cough, respiratory distress, and chest indrawing. Eight of nine required respiratory support. Of these, 4 required oxygen for 3 days, 2 for 4 days, 1 for 2 days, and 1 for 1 day. RT-PCR detected RSV type B in 8 cases and type A in 1 case. Chest X-rays showed haziness in 56%, patchy opacities in 33%, lung collapse in 11%. Bronchodilators were administered in 89% of cases; none received antiviral treatment and were discharged without mortality. RSV infection in neonates leads to significant respiratory morbidity requiring oxygen and ventilatory support. Despite clinical severity, favourable outcomes were observed. Early detection and supportive care remain critical in RSV management.