Respiratory Syncytial Virus Infection Management

Infection Control Measures

Hand hygiene is the most important strategy for reducing RSV transmission, with hands being decontaminated before and after direct patient contact, after contact with objects in the patient's vicinity, and after removing gloves, as recommended by the American Academy of Pediatrics 2
Alcohol-based hand rubs are preferred for hand decontamination when hands are not visibly soiled, according to the American Academy of Pediatrics 2
Education of healthcare personnel and family members about hand hygiene and infection prevention is essential, as emphasized by the American Academy of Pediatrics 2
Isolation or cohorting of RSV-positive patients is effective in reducing nosocomial spread, as recommended by the Centers for Disease Control and Prevention and the American Academy of Pediatrics 2, 3
Contact precautions, including gloves and gowns for direct patient contact, help minimize transmission, according to the American Academy of Pediatrics and the European Rhinologic Society 2, 4
Restricting visitors with respiratory symptoms from visiting high-risk patients is recommended by the Centers for Disease Control and Prevention 3

Breastfeeding is recommended to decrease a child's risk of having lower respiratory infections, as suggested by the American Academy of Pediatrics 2
Avoiding exposure to tobacco smoke is important as it increases the risk of severe RSV disease, according to the American Academy of Pediatrics 2
RSV vaccines for pregnant women between weeks 24 and 36 of gestation can provide passive protection to infants from birth through 6 months of age, as recommended by the American College of Obstetricians and Gynecologists and the Pulmonology society 6

RSV vaccination is recommended for all adults aged ≥60 years and adults aged 50-59 years with risk factors, such as chronic respiratory disease, heart disease, kidney disease, diabetes, immunocompromised status, obesity, neurological conditions, or residence in long-term care facilities, according to the National Foundation for Infectious Diseases and the Pulmonology society 5, 6
Available vaccines include RSVPreF3 (Arexvy) and RSVpreF (Abrysvo), administered as a single intramuscular dose, preferably between September and November, as recommended by the National Foundation for Infectious Diseases and the Pulmonology society 5, 6

Aerosolized or systemic ribavirin may be considered for treatment of RSV lower respiratory tract disease in allogeneic hematopoietic stem cell transplant recipients, as suggested by the Infectious Diseases Society of America 7
Intravenous immunoglobulin (IVIG) may be combined with ribavirin therapy in these high-risk patients, according to the Infectious Diseases Society of America 7
Deferral of conditioning therapy should be considered for patients with RSV respiratory tract infection planned for allogeneic hematopoietic stem cell transplantation, as recommended by the Infectious Diseases Society of America 7