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Siblings Sharing Everything, Including Viruses: Age-based Visitor Restriction as a Successful Infection Prevention Measure in a Children's Hospital Open Access

Background. As seasonal respiratory virus activity increases in the Pacific Northwest region, enhanced infection prevention measures are annually implemented in our tertiary-care university children's hospital. To minimize our most vulnerable patients' risk of healthcare-associated infection (HAI), these measures focus on the pediatric hematology/oncology inpatient unit and outpatient clinic.

Methods. During the 2013-2014 season, in addition to placing all patients with suspected or confirmed respiratory viral illness in contact and droplet isolation precautions, the following enhanced infection prevention measures were enacted at different time-points: Beginning December 16, 2013, all employees and visitors to the pediatric hematology/oncology inpatient unit and outpatient clinic were required to check-in at the front desk, sign an attestation form confirming no respiratory viral symptoms, and wear a day-of-the-week sticker as proof that active screening was complete. Beginning January 6, 2014, (1) all bone marrow transplant (BMT) patients were placed in contact and droplet isolation precautions (regardless of respiratory symptoms) if <100 days post-BMT or >100 days if severely immunosuppressed with active graft-vs-host-disease (GVHD), and (2) no visitor <12 years of age was allowed entry to the pediatric hematology/oncology inpatient unit, including siblings.

Active laboratory surveillance was performed by the Department of Infection Prevention and Control. HAI case definitions were defined for respiratory syncytial virus (RSV), parainfluenza, influenza, adenovirus, rhinovirus and metapneumovirus.

Results. Despite rigorous employee and visitor symptom screening, 2 respiratory viral HAI cases occurred. However, after implementation of age-based visitor restrictions and expanded isolation precautions for BMT patients, no additional HAI cases have been identified to date.

Conclusion. Regardless of a season in which sustained, moderate respiratory viral activity was noted in the community, an enhanced infection prevention policy focusing on restricting young visitors effectively assisted in preventing respiratory viral HAI in our pediatric hematology/oncology unit.

Disclosures. All authors: No reported disclosures.

Author notes