Another NICU has been closed due to an outbreak of respiratory illnesses among several high-risk babies at London’s only neonatal intensive-care unit.
Seven of the 35 infants in the NICU at St. Joseph’s hospital tested positive for parainfluenza type 3 or respiratory syncytial virus this week, and the unit has responded by shutting its doors to new patients.
“When an outbreak occurs . . . you don’t bring in new, premature babies. They’re like sitting ducks,” Dr. Michael John, medical director of infection prevention and control with London’s hospitals, said yesterday.
“These little babies are the ones that are most likely to do badly if they get infections, and particularly lung infections.”
Indications of an outbreak surfaced last Monday, when two infants recently released from the NICU started requiring more oxygen than before, which is a sign of a respiratory illness, John said.
Both babies were screened — plus two others they’d shared an NICU room with — and results showed all four babies had viral respiratory illnesses.
Three of those babies tested positive for parainfluenza type 3, while the fourth infant showed positive for both parainfluenza type 3 and RSV, John said.
“After that, we decided to test all the babies.”
Three more babies tested positive for RSV or parainfluenza type 3 or both, he said.
None of the babies are critically ill, he said.
Both infections are common in young children — John said 95 per cent of two-year-olds have already suffered from parainfluenza * — and usually, they don’t cause more harm than a few sniffles or croup.
But in high-risk babies, such as the premature or unwell babies housed in the NICU, the viral respiratory illnesses can cause severe problems, he said.
“These (illnesses) might be relatively trivial infections in others, but these little premature babies are at risk for serious complications” such as pneumonia and difficulty breathing, he said.
All of the unit’s 35 babies have been given an antibody designed to fight RSV, and special precautions are being undertaken to ensure there is no further spread.
There is no antibody to ward off parainfluenza, John said.
Doctors decided yesterday to close off the unit to new babies for a period of 24 hours, until the situation can be reassessed, he said.
For now, the NICU is closed to any new preemies, and high-risk mothers who will be delivering may have to do so at other area hospitals if the unit remains closed, he said.
“We can’t afford to have new, very premature babies coming in,” John said.
Toronto, Hamilton and Ottawa all have NICU units for high-risk babies.
John added it’s unclear whether any of the babies in St. Joseph’s NICU are actually suffering from RSV because the first screening tests administered to the babies have been known to show false positives for the illness.
It’s also rare for RSV to present itself outside of the winter months, he said.
All of the babies have been tested again to determine whether RSV is present, and the hospital hopes to have the results of those tests by 5 p.m. today.
Doctors will decide at that point whether to maintain the unit closure or re-open to new babies, he said.
Anyone whose baby has been discharged from the NICU within the last week and shows symptoms such as rapid breathing, cough or a fever is asked to go to Children’s Emergency for medical care.
The good news is that all the babies are alive. Women’s College NICU was closed in March and Mount Sinai Hospital in May due infection outbreaks.
It doesn’t take much for infection to spread in the intensive care units. All it takes is just one or two parents to come in, not wash their hands properly and then pass their illness to everyone else.
You are supposed to wash your hands for 2 minutes before heading to the bedside, but no one ever does…Maybe there should be a small timer by each wash sink so that everyone knows exactly how long 2 minutes is?