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Heidelberg, Germany

Respiratory syncytial virus (RSV) infections usually cause minor upper respiratory tract infections, but might also infect the lower respiratory tract presenting with coughing and dyspnoea. All age groups are susceptible to RSV infections, mostly newborns and small children. Due to incomplete immunity after primary infection, reinfections in children and adults are quite common. Patients with haematological malignancies and stem cell transplant patients have a high risk of developping pneumonia after RSV infection and are shedding the virus for many weeks. During winter time, the number of infections is high and peaks for four to eight weeks. Early detection of RSV in respiratory samples is of high importance, in order to install proper hygiene measures, e.g. isolation of the infected patient. Strict hygiene barriers are necessary, health care workers need to use gloves, gowns and glasses during contact with infected patients. Patients at risk are not allowed to have contact with visitors or medical personnel who present with respiratory symptoms. During an outbreak situation on haematological wards, all patients need to be screened for RSV. Depending on the RSV Leukästatus of the patients, special hygiene and therapeutic measures are recommended for stem cell transplant patients. Prospective randomised studies are necessary comparing several therapeutic options, e.g. ribavirin, immunoglobulin and Palivizumab prophylaxis in high risk patients.

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