Neonatal Respiratory Syncytial Virus Infection

TLDR

Respiratory syncytial virus infections are considered rare in the first month of life. We prospectively studied neonatal RSV infection during a community outbreak in our neonatal units. Among 82 neonates studied, 23 (35%) acquired RSV, 66 were hospitalized ≥6 days, four died (two unexpected), infected infants had shorter gestation and birth weight, presented atypically with nonspecific signs, less lower‑respiratory‑tract involvement, lower nasal virus loads, and viral shedding correlated with postnatal age; 34% of staff were infected, indicating possible staff‑to‑neonate transmission and highlighting that RSV can readily infect neonates but may be overlooked. N Engl J Med 300:393–396, 1979.

Abstract

Respiratory syncytial virus infections are thought to be uncommon in the first month of life. During a community outbreak, we prospectively studied such infection in our neonatal units. Of 82 neonates studied, 66 were hospitalized for six days or longer, and 23 (35 per cent) acquired this virus. Four infants died, two unexpectedly. Infected infants had a significantly shorter gestation and birth weight. Illness was often atypical, with nonspecific signs, especially in infants under three weeks of age, who had significantly less lower-respiratory-tract involvement and lower quantities of virus in their nasal washes. The titer of virus shed correlated with the infants' postnatal, but not gestational, age. Infection was also acquired by 34 per cent of the staff, who appeared to be important in the spread of the virus. These findings suggest that respiratory syncytial virus may readily infect neonates, but the disease may be atypical and may be overlooked. (N Engl J Med 300:393–396, 1979)