Respiratory syncytial virus outbreaks in healthcare facilities: A review of the literature.

Respiratory syncytial virus (RSV) is a leading cause of respiratory infections. Outbreaks have occurred in various healthcare settings. We reviewed RSV outbreaks in healthcare facilities. PubMed was searched from 2010 to 2025 for articles on RSV outbreaks in healthcare facilities. Eighteen articles presenting 19 RSV outbreaks were reviewed. Eleven outbreaks occurred in hematology/oncology/transplantation wards/units, six in neonatal intensive care units (NICUs), and two in geriatric hospitals/long-term care facilities (LTCFs). The mean attack rate across all outbreaks was 26.04% (range: 12.00%-68.96%) and the mean duration was 39.9 (range: 5-131) days. A mean of 20.31 (range: 4-63) patients were affected per outbreak. Asymptomatic or mildly symptomatic healthcare personnel (HCP) were the most frequent sources of infection. RSV disease was particularly severe in premature neonates and immunosuppressed patients. Prolonged virus shedding also occurred among premature neonates and immunosuppressed patients, challenging the containment of outbreaks. The overall case fatality rate (CFR) among RSV-infected patients was 11.64% (mean CFR: 13.99% in hematology/oncology/transplantation units, 6.49% in NICUs, and 6.25% in geriatric clinics). Palivizumab prophylaxis was temporally associated with outbreak control when used as part of multimodal interventions. In conclusion, serious RSV outbreaks occur in healthcare facilities caring for vulnerable patients. Such outbreaks are frequently traced to HCP, usually last several weeks, and affect many patients, which emphasize the transmission dynamics of RSV within healthcare facilities but also disclose gaps in infection control. Elderly patients, residents of LTCFs, and immunocompromised patients should be vaccinated against RSV. Palivizumab prophylaxis should be studied.