Respiratory Syncytial Virus

Prevention of severe RSV in children and adults will be critical this respiratory season.

October 2023- The Journal of Healthcare Contracting

As it begins to get colder and darker outside, experiencing mild, cold-like symptoms including cough, runny nose, sore throat, and headache is common. Most everyone at some point in their life will experience symptoms of the common cold, which are often not serious, and healthy people can likely recover quickly. However, for individuals that are immunocompromised, cold symptoms associated with Respiratory Syncytial Virus (RSV) could progress to become more severe and life-threatening.

During respiratory season, the groups that are most at risk of severe RSV illness are babies, young children, and older adults. In healthy individuals, RSV causes mild symptoms that most adults can recover from within a week or two. However, for children and for adults over age 65, RSV is more likely to cause disease complications and require medical attention.

The peak season for RSV infection in the United States is fall through spring. RSV is spread through close contact with an infected person’s secretions from coughing, sneezing, and talking. After being infected, patients usually exhibit symptoms such as a runny nose, decrease in appetite, coughing, sneezing, fever, and wheezing, that develop in varying stages within four to six days, according to the Centers for Disease Control and Prevention (CDC). 

RSV in young children

Most children will likely contract RSV before the age of two from exposure to others outside the home. Babies with weakened immune systems are more at risk of developing severe forms of RSV, according to the American Lung Association. Infants and young children infected with RSV may only exhibit the symptoms of irritability, decreased activity, and breathing difficulty.

“Certain risk factors can make young babies more likely to catch RSV, including being underweight, having congenital heart disease, a weakened immune system, or premature birth,” said Dr. Tochi Iroku-Malize, President of the American Academy of Physicians.

Symptoms should clear within a few days on their own; however, if they do not, the illness may have progressed into something more serious. Severe illness associated with RSV in children includes a barking or wheezing cough, and short, shallow, rapid breathing. These symptoms indicate an infection of the lower respiratory tract, according to the American Lung Association. RSV can cause bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in severe cases, according to the CDC. If a child shows signs of severe RSV, contact a healthcare provider immediately or seek emergency care.

“If infections are left untreated, they can lead to serious conditions like bronchitis or pneumonia. Symptoms of RSV can be different based on age. The virus is most common in children under two, but babies who are less than a year old and premature babies typically have more serious symptoms. These include runny nose, poor appetite, coughing, fever, difficulty breathing, red and swollen tonsils, headache, abdominal pain, vomiting and rashes,” according to Dr. Iroku-Malize.

The Food and Drug Administration (FDA) approved a vaccine in July of 2023 to protect infants and toddlers against RSV. According to the FDA, the vaccine will offer infants through children up to 24 months protection before entering their first (or second) RSV season.

RSV infection prevention for adults

RSV symptoms for adults are very similar to those associated with the common cold and include a runny nose, sore throat, cough, and headache. For older adults, especially those with lung or heart disease such as asthma, congestive heart failure, or chronic obstructive pulmonary disease (COPD), the risk of RSV becoming severe or life-threatening increases, according to the American Lung Association.

For individuals with these preexisting conditions, an RSV infection can cause a worsening of asthma or COPD symptoms, pneumonia (air sacs/alveoli in lungs becoming inflamed and filled with fluid), bronchiolitis (inflammation of the small airways in the lungs), or severe cardiac symptoms.

“If patients have any symptoms of RSV, or have chronic conditions that put them at greater risk of getting very sick, they should see their family physician. They can then determine the best course of action to help make sure they’re getting the care they need before it becomes more serious or they develop complications,” according to Dr. Iroku-Malize.

Older adults face increased risks from RSV due to their age and potential for the disease to interfere with underlying medical conditions. It is estimated by the CDC that between 60,000-160,000 older adults in the U.S. are hospitalized due to RSV each year. For adults aged 60 and older, receiving the RSV vaccine can help protect from the disease, according to the CDC.

“Vaccination against RSV could lead to less serious illness for older adults and fewer hospitalizations and deaths from RSV. Family physicians are well-equipped to counsel patients on whether the vaccine is right for them and administer vaccines right in the office,” said Dr. Iroku-Malize. “Physicians are in a unique position to address misinformation and myths about vaccinations and address patients’ questions and concerns. Patients should talk to their family doctor if they’re unsure about vaccinations and whether or not they should get a certain vaccine.”

Older adults should seek emergency care if they suspect they are experiencing severe RSV or have shortness of breath, a fever, a bluish skin tint, wheezing, or a worsening cough.

To prevent the spread of RSV, individuals should wash their hands often, avoid close contact with sick people, and disinfect frequently touched surfaces.

“In addition to receiving available vaccines, preventive measures like washing your hands often, covering your mouth when you cough, avoiding sharing food, utensils and other items and staying home when you’re sick are important ways to stop the spread of viruses. Patients can also count on their family doctors to provide them with accurate information and recommendations on how to avoid respiratory illnesses and stay healthy,” according to Dr. Iroku-Malize.

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