Mysterious wave of infections in the cancer ward



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Numerous RSV infections at Heidelberg University Hospital

An enigmatic accumulation of infections with the so-called RS virus has occurred in the Heidelberg University Clinic. The normally harmless pathogens can have life-threatening consequences in children and patients with weakened immune systems. According to the clinic, three patients may have already died of infection with the virus.

The RS virus (Respiratory Syncytial Virus, RSV) usually only causes a harmless cold in people with an intact immune system. But the already weakened patients in the hospital are at risk of far worse health impairments. The spread of the pathogens in the Heidelberg University Clinic must be assessed accordingly. Since the beginning of the year, 19 patients in two cancer wards and in the intensive care unit had contracted the RS virus. A spokeswoman for the clinic emphasized that the situation was under control and no patients were at risk, but she also had to admit that "the pathogen was found in three patients who died during this period". According to the clinic spokeswoman, "a causal connection" between the deaths and the RS virus can therefore "not be excluded".

RS virus particularly dangerous for children and with a weakened immune system According to the clinic spokeswoman, the accumulation of infections with the RS virus at the Heidelberg University Hospital is extremely unusual and only "individual cases would be normal". However, no further information is available on the causes of the wave of infections. The RSV infections were reported to the health authority in accordance with the provisions of the Infection Protection Act. At the same time, the clinic initiated extensive investigations into the possible transmission routes in order to avoid further infections. The RS virus belongs to the Paramyxoviridae family, which also includes the measles and mumps virus. They usually cause harmless colds, but are also considered to be one of the most common triggers of lower respiratory tract infections and pneumonia in infants and young children. In addition, the viruses often result in serious respiratory infections, particularly in older, weakened patients. Children under the age of two years and babies under the age of six months are usually most commonly affected. Complications and serious illnesses occur especially in small children but also in patients with weakened immune systems and previous diseases of the lungs or heart.

Accumulation of RSV infections in university clinic extremely critical Therefore, the spread of RS viruses at Heidelberg University Hospital is to be assessed particularly critically. Here the RSV infections were detected in the three wards of the Hematology, Oncology and Rheumatology Department, where mostly seriously ill patients are treated with various forms of blood cancer. The medical director of the clinic, Professor Anthony Ho, explained that "some patients receive a stem cell transplant or chemotherapy" and "their immune system is no longer intact". Accordingly, the "risk of developing severe pneumonia" is significantly increased, according to the doctor. If the course of the disease is particularly severe, “ventilation may be required”, which is why the three deceased patients were last treated in the intensive care unit of the gastroenterology department, said Ho.

Possible connection between RSV infections and three deaths To what extent there is a connection between the deaths and the spread of RS viruses at Heidelberg University Hospital has not yet been clarified. Medical Director Professor Anthony Ho also emphasized: "It is unclear whether the RSV infection was the cause of the death of the seriously ill patients, because the patients have many problems, but it cannot be ruled out." The route of infection remains unclear so far . The RS viruses are transmitted by droplet infection, whereby the pathogens can be passed on from person to person, for example when coughing or sneezing, as an aerosol (tiny droplets in the air). Even with close skin contact with infected people, there is a significantly increased risk of transmission. The pathogens then usually enter the body via the nasal mucosa or the conjunctiva of the eye, where they nest and multiply on the mucous membranes of the respiratory tract. According to the experts, the incubation period is approximately two to eight days after contact with the RS virus.

Searching for the causes of RSV infections In order to track down the spread of the RS virus, the clinic management of Heidelberg University Hospital ordered a test for the virus from 200 hospital employees and around 70 patients. However, according to the clinic spokeswoman, only one other case was discovered, which is a "weakly infected" employee who is currently not on duty. The result of a second test is expected in the coming days. In addition, additional hygiene measures have been established to prevent the pathogens from spreading further. "We have done everything possible to interrupt the infection chain and to protect additional patients and employees," emphasized the acting medical director of the Heidelberg University Hospital, Peter Nawroth.

Additional hygiene measures to interrupt the infection chain For example, the infected patients were isolated, the staff were given special masks and a stop for visitors was pronounced for people with respiratory infections. In addition, the hospital management imposed a stop on admission for patients who do not necessarily need surgery. An interruption of the infection chain "seems to us to be successful" because no further infections have occurred since January 17, 2012, explained Peter Nawroth. To date, however, "it must have been disseminated somewhere," explained the clinic spokeswoman. The cause of the spread of RS viruses in the cancer ward of the university hospital remains completely open despite the apparently successful containment. Therefore, the university hospital requested the experts from the Robert Koch Institute (RKI). These should help to trace the causes of the wave of infections. (fp)

Image: Electron microscope image of a respiratory syncytial virus (RSV)

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