RSV hospitalization rate among seniors is 10 times higher than usual at this stage of the season


Respiratory virus season started early in children this year and has flooded children’s hospitals in many parts of the country – particularly with respiratory syncytial virus, known as RSV.

But adults can also catch RSV. Although RSV doesn’t usually send as many adults to the hospital, it can be a serious and even fatal illness for older adults and people with underlying health conditions.

And with more children catching RSV, the chances of adults being exposed are also increasing. Some doctors say they are starting to see an increase in adult patients.

This season, about 6 in 100,000 seniors have been hospitalized with RSV, according to data from the US Centers for Disease Control and Prevention. This is significantly lower than the rate for children, but still unusually high. In the years before the Covid-19 pandemic, hospitalization rates for the elderly were around 10 times lower at this point in the season.

Dr Ann Falsey, a professor of infectious diseases at the University of Rochester Medical Center who has published research on RSV in adults, said RSV had increased somewhat in children over the summer and from the beginning of last fall, but that the United States had not observed the usual proportional rate. increase in RSV in the elderly at the time.

“I think older people were more cautious about continuing public health measures like masks and social distancing last year because they were still worried about Covid,” Falsey said. “But this year we’re starting to see older people end up in hospital again with RSV, because everyone’s ignoring caution.”

Too often, RSV flies under the radar in adults, she said. Many people, even doctors, overlook its impact on adults.

“They think it’s strictly a pediatric disease, but you know, if you don’t test it, you’ll never know what someone is actually sick with,” Falsey said.

In the United States, tracking of viruses like RSV is not as thorough as for Covid-19, so it is difficult to know exactly how many adults are getting sick with RSV. RSV case counts come from self-reports that are forwarded to a few dozen labs that represent only about a tenth of the population, and the reports are then shared with the CDC.

Best estimates are that there are between 10,000 and 15,000 adult deaths in the United States from RSV each year and about 150,000 RSV hospitalizations, Falsey said.

A 2015 study of older people in industrialized countries said the disease burden of RSV is “substantial” and calculated that around 14.5% of the 1.5 million adults who have contracted RSV have been admitted to hospital. People aged 65 and over were more likely to be hospitalized than those aged 50 to 64.

“When you compare it to influenza A, it’s not too far behind,” Falsey said, referring to one of the seasonal flu strains that is often linked to more severe illness.

RSV appears in adults in the same way as in children. It can feel like a cold and include a runny nose, decreased appetite, coughing, sneezing, fever, and wheezing. Symptoms usually last a week or two and go away with rest and fluids.

But in some adults, RSV can become dangerous because it can lead to dehydration, trouble breathing, and more serious illnesses such as pneumonia and bronchiolitis, inflammation of the tiny airways in the lungs.

Adults most at risk of serious outcomes with RSV are those 65 years of age and older. The virus can spread quickly in a nursing home or long-term care facility, just like Covid-19 and the flu.

Adults with weakened immune systems should be cautious during RSV season. This can include people undergoing cancer treatment, transplant patients, people with HIV, and those taking certain drugs that suppress the immune system for conditions like Crohn’s disease, lupus, or rheumatoid arthritis.

Adults with chronic heart or lung disease such as asthma, COPD or heart failure are also more likely to need to go to hospital if they catch RSV.

An infected person can transmit RSV by coughing or sneezing. If the respiratory droplets land on a surface like a doorknob or desk and someone else touches her and then touches her face, she can get sick.

It also spreads because healthy adults often don’t know they have it. It doesn’t usually cause fatigue like the flu or Covid, so many adults will go to work or hop on a plane or bus, blaming their symptoms on allergies. As they interact with others, it spreads further.

RSV can also be transmitted easily from children to adults.

If you’ve had a cough or other RSV-like symptoms and you fall into a high-risk category, you should see your doctor and have it checked out, says Dr. Daphne-Dominique Villanueva.

“We can’t test everyone right now — in an ideal world, we would want to — but we want to focus on vulnerable people,” said Villanueva, an assistant professor at the West College of Medicine. Virginia University who wrote studies. about RSV.

Doctors’ offices have swab tests that can determine if an illness is influenza, RSV or Covid.

There are specific antivirals for influenza and Covid-19 but not for RSV. The trick is to get tested early, even to rule out RSV; Starting Covid or flu antivirals right away can shorten the duration of your illness and prevent the virus from progressing to something more serious.

With RSV, the treatment is called supportive care: drink plenty of fluids. Take a real rest. Stay home so you don’t spread it. Wear a mask around others in your home.

If you start to wheeze and feel short of breath, Falsey said, those would be clear signals that you should see a doctor or maybe even get to the emergency room quickly. In the hospital, they can give you extra oxygen if needed.

There is no RSV protection, but that could change by next season. In the United States, four RSV vaccines may be on the verge of FDA review, and more than a dozen are in trials. Some are designed to protect infants, and some are tested in the elderly.

“Since we have very limited ways to treat it effectively, you have to do everything you can to avoid catching it in the first place,” Villanueva said.

Protective measures for this busy RSV season will sound familiar: wash your hands frequently, disinfect surfaces, and wear a mask in crowded spaces.

“You might want to postpone that visit for a week to see your grandkids, or you might want to wear a mask if you’re going somewhere crowded,” Falsey said. “Masks and handwashing work. I know people are a bit over the top, but if you’re a frail person or you know you have underlying health conditions, when we know RSV is on the rise, you need to do those things and be caution with children who are actively ill. Everything helps.


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