ABSTRACT
Viral infections, in particular, have a high mortality rate in HSCT units and present particular problems, both because they cannot be easily prevented with antiviral therapy and because spread cannot be prevented by HEPA (high-efficiency particulate air) filtration 15-71. And while significant progress has been made in the prevention and management of many infections due to reactivation of pathogens, such as cytomegalovirus (CMV), little gain has been made in reducing the risk of infection contracted from hospital staff and the environment. The reasons for this are complex and include medical, occupational, financial and cultural factors. The end result is that while some infection control measures, such as hand washing, the wearing of masks and mandatory influenza vaccination of staff working in HSCT units, has become accepted practice throughout the developed world, other measures, including the monitoring of HSCT staff for viral shedding, the screening and exclusion of children from HSCT units and the relocation of staff who have symptoms of viral upper respiratory tract infection, have proven more contentious.
