The Royal Liverpool Children’s Hospital—Alder Hey pediatric intensive care unit (PICU) usually has a low rate of nosocomial respiratory syncytial virus (RSV) infection.

We report and analyze a major outbreak of nosocomial (acquired) RSV infection on the PICU during a RSV season.

All children admitted to the PICU were studied during the six-month winter period 1 October 2002 to 31 March 2002.

Nasopharyngeal aspirates were tested using an in vitro enzyme-linked immunoassay (ELISA) membrane test for RSV antigen.

PICU-acquired RSV infection was considered to have occurred when a child admitted to the PICU was RSV negative, or from whom no samples were taken as they did not exhibit signs of bronchiolitis, but was RSV positive five or more days after the admission.

Fifty-four patients tested RSV positive using the ELISA on the PICU.

All the patients were ventilated. Thirty-nine children were RSV positive using the ELISA on admission to the PICU (‘imported’ cases) and 15 became RSV positive whilst on the PICU (‘acquired’ cases).

The source of the acquired RSV infection accounting for the first peak/outbreak in nosocomial cases were RSV-positive children in isolation cubicles.

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