Respiratory viruses in transplant recipients: more than just a cold. Clinical syndromes and infection prevention principles. (September 2017)

• Record Type: Journal Article
• Authors: Abbas, Salma; Raybould, Jillian E.; Sastry, Sangeeta; de la Cruz, Oveimar
• Is Part Of: International journal of infectious diseases. Volume 62(2017:Sep.)
• Page Start: 86
• Page End: 93
• Publication Date: 2017-09
• Subjects: Respiratory viral infections -- Transplant recipients -- Infection prevention; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2017.07.011
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Respiratory viral infections are associated with high morbidity and mortality among transplant recipients. The infections typically occur within the first 6 months after transplantation. Currently, management options are limited or lack strong clinical evidence. Infection control practices vary across institutions. Vigilant hand washing and other standard precautions are key to preventing outbreaks. Abstract: Objectives: The aim of this review is to provide updated information on the clinical spectrum, treatment options, and infection prevention strategies for respiratory viral infections (RVIs) in both solid organ (SOT) and hematopoietic stem cell transplant (HSCT) patients. Methods: The MEDLINE and PubMed databases were searched for literature regarding the aforementioned aspects of RVIs, with focus on respiratory syncytial virus, adenovirus, influenza virus, parainfluenza virus, human metapneumovirus, and rhinovirus. Results: Compared to immunocompetent hosts, SOT and HSCT patients are much more likely to experience a prolonged duration of illness, prolonged shedding, and progression of upper respiratory tract disease to pneumonia when infected with respiratory viruses. Adenovirus and respiratory syncytial virus tend to have the highest mortality and risk for disseminated disease, but all the RVIs are associated with higher morbidity and mortality in these patients than in the general population. These viruses are spread via direct contact and aerosolized droplets, and nosocomial spread has been reported. Conclusions: RVIs are associated with high morbidity and mortality among SOT and HSCT recipients. Management options are currently limited or lack strong clinical evidence. As community and nosocomial spread has been reported for all reviewed RVIs, strict adherence to infection control measures is key to preventing outbreaks.