Nosocomial Respiratory Syncytial Virus in the Post-Pandemic Era: Evolving Epidemiology and Integrated Prevention Strategies.
7 affiliations
- 1Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Section 4, Taichung 407219, Taiwan.
- 2Infection Control Center, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Section 4, Taichung 407219, Taiwan.
- 3Genomic Center for Infectious Diseases, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Section 4, Taichung 407219, Taiwan.
- 4School of Medicine, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Beitou District, Taipei 112304, Taiwan.
- 5Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, 145 Xingda Road, South District, Taichung 402202, Taiwan.
- 6Doctoral Program in Translational Medicine, Rong Hsing Translational Medicine Research Center, National Chung Hsing University, 145 Xingda Road, South District, Taichung 402202, Taiwan.
- 7Institute of Clinical Medicine, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Beitou District, Taipei 112304, Taiwan.
Abstract
Background/objectives
Pandemic non-pharmaceutical interventions virtually eliminated respiratory syncytial virus (RSV) circulation in 2020-2021, and their relaxation was followed by unprecedented off-season resurgences. This narrative review, informed by a structured literature search, synthesizes current evidence on healthcare-associated RSV (HA-RSV), including transmission dynamics, vulnerable inpatient populations, and integrated prevention strategies, in the post-pandemic era.Methods
We searched PubMed/MEDLINE and Europe PMC (January 2000-October 2025) using two complementary strategies, supplemented by WHO and CDC guidance. Primary hospital-based studies reporting laboratory-confirmed HA-RSV cases formed the core evidence set; surveillance reports, systematic reviews, and guidance were used as labeled contextual evidence and synthesized narratively.Results
Twenty-nine primary studies from neonatal, pediatric, adult, geriatric, and immunocompromised settings provided direct evidence on HA-RSV, which accounted for 3-15% of RSV hospitalizations depending on setting and case definition and was associated with prolonged stay, escalation of respiratory support, higher costs, and, in children, higher mortality than community-onset infection. Universal masking and pre-admission screening were followed by reductions in HA-RSV in most before-after studies. Post-pandemic surveillance shows earlier, less predictable RSV activity and periods of concurrent circulation with influenza and SARS-CoV-2. RSV spreads mainly through short-range respiratory particles and contaminated hands and surfaces; asymptomatic or mildly symptomatic healthcare workers are one potential source of introduction.Conclusions
Prevention of HA-RSV rests on hand hygiene, transmission-based precautions, environmental disinfection, rapid molecular diagnostics, and supportive healthcare-worker and visitor policies, escalated according to local surveillance rather than the calendar. Immunoprophylaxis and vaccination reduce severe RSV disease in eligible groups, but direct evidence that they prevent healthcare-associated transmission is lacking.
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BibTeX
@article{huang2026nosocomial,
title = {{Nosocomial Respiratory Syncytial Virus in the Post-Pandemic Era: Evolving Epidemiology and Integrated Prevention Strategies.}},
author = {Po-Hsiu Huang and Pei-Hsuan Huang and Po-Yu Liu and Ting-Kuang Yeh},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14193335},
url = {https://europepmc.org/article/MED/42881774},
note = {CC BY},
}
RIS
TY - JOUR
TI - Nosocomial Respiratory Syncytial Virus in the Post-Pandemic Era: Evolving Epidemiology and Integrated Prevention Strategies.
AU - Po-Hsiu Huang
AU - Pei-Hsuan Huang
AU - Po-Yu Liu
AU - Ting-Kuang Yeh
PY - 2026
DA - 2026/10/06
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14193335
UR - https://europepmc.org/article/MED/42881774
AB - Background/objectives Pandemic non-pharmaceutical interventions virtually eliminated respiratory syncytial virus (RSV) circulation in 2020-2021, and their relaxation was followed by unprecedented off-season resurgences. This narrative review, informed by a structured literature search, synthesizes current evidence on healthcare-associated RSV (HA-RSV), including transmission dynamics, vulnerable inpatient populations, and integrated prevention strategies, in the post-pandemic era.Methods We searched PubMed/MEDLINE and Europe PMC (January 2000-October 2025) using two complementary strategies, supplemented by WHO and CDC guidance. Primary hospital-based studies reporting laboratory-confirmed HA-RSV cases formed the core evidence set; surveillance reports, systematic reviews, and guidance were used as labeled contextual evidence and synthesized narratively.Results Twenty-nine primary studies from neonatal, pediatric, adult, geriatric, and immunocompromised settings provided direct evidence on HA-RSV, which accounted for 3-15% of RSV hospitalizations depending on setting and case definition and was associated with prolonged stay, escalation of respiratory support, higher costs, and, in children, higher mortality than community-onset infection. Universal masking and pre-admission screening were followed by reductions in HA-RSV in most before-after studies. Post-pandemic surveillance shows earlier, less predictable RSV activity and periods of concurrent circulation with influenza and SARS-CoV-2. RSV spreads mainly through short-range respiratory particles and contaminated hands and surfaces; asymptomatic or mildly symptomatic healthcare workers are one potential source of introduction.Conclusions Prevention of HA-RSV rests on hand hygiene, transmission-based precautions, environmental disinfection, rapid molecular diagnostics, and supportive healthcare-worker and visitor policies, escalated according to local surveillance rather than the calendar. Immunoprophylaxis and vaccination reduce severe RSV disease in eligible groups, but direct evidence that they prevent healthcare-associated transmission is lacking.
SN - 2227-9032
ER -