The RSV hospitalization rate for the elderly is 10 times higher than normal this season



CNN

Respiratory virus season has started early this year in children and has overwhelmed children’s hospitals in various parts of the country, especially with the respiratory syncytial virus, also known as RSV.

But adults can also get RSV. Although RSV does not usually send many adults to the hospital, it can be a serious and even fatal illness for the elderly and people with underlying health conditions.

And as more children get RSV, the chances that adults will be infected also increases. Some doctors say they are starting to see an increase in older patients.

This season, about 6 in 100,000 seniors are 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 not very high. In the years before the Covid-19 pandemic, hospitalization rates for the elderly were approximately 10 times higher than at this time of 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 rose slightly in children last summer and early fall, but the U.S. did not see the usual proportional increase. The rise of RSV in older adults at that time.

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

Often times, RSV flies under the radar in adults, he said. Many people, even doctors, overlook the effect it has on adults.

“They think it’s a pediatric disease, but you know, if you don’t get tested, you’ll never know what he’s really sick with,” Falsey said.

In the United States, tracking of viruses like RSV is not as accurate as it is for Covid-19, so it’s difficult to know exactly how many adults get sick with RSV. The number of RSV cases comes from self-reports of only a few dozen in the population, and the reports are shared with the CDC.

Based on the best estimates, 10,000 to 15,000 adults die from RSV and about 150,000 hospitalizations from RSV each year in the United States, Falsey said.

A 2015 study of older adults in industrialized countries called the disease burden of RSV “significant” and estimated that about 14.5% of the 1.5 million adults who contracted RSV were hospitalized. People over the age of 65 were more likely to be hospitalized than people between the ages of 50 and 64.

“When we compare it to influenza A, it’s not far behind,” Falsey said, referring to one of the seasonal flu strains associated with more severe illness.

RSV appears in adults as it does in children. It can look like a common cold and include a runny nose, loss of appetite, cough, sneezing, fever and wheezing. Symptoms usually last a week or two and clear up with rest and fluids.

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

Adults at greatest risk of serious complications from RSV are those 65 and older. The virus can spread quickly in nursing homes or long-term care facilities, similar to Covid-19 and the flu.

Adults with weakened immune systems should be careful during RSV season. These may include people undergoing treatment for cancer, transplant patients, people with HIV, and those taking certain drugs that suppress the immune system for diseases such as Crohn’s, lupus, or rheumatoid arthritis.

Adults with chronic heart or lung conditions such as asthma, COPD, or heart failure may also need to go to the hospital if they catch RSV.

An infected person can spread RSV by coughing or sneezing. If respiratory droplets land on a surface like a doorknob or a desk and someone else touches them and then touches their face, they can get sick.

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

RSV can easily spread from children to adults as well.

If you’ve had a cough or other RSV-like symptoms and are in the high-risk category, you should go to your doctor and get checked out, says Dr. Daphne-Dominique Villanueva.

“Right now we can’t test everyone — in an ideal world we’d like to do that — but we want to concentrate on the most vulnerable people,” said Villanueva, an assistant professor at the West Virginia University School of Medicine who wrote the study. About RSV

Doctor’s offices have swab tests to determine if an illness is the flu, RSV, or Covid.

There are specific antivirals for influenza and Covid-19, but not for RSV. The trick is being tested early, even to rule out RSV; Getting a covid or flu vaccine right away can shorten the time you are sick and prevent the virus from developing into something more serious.

With RSV, the treatment is so-called supportive care: drink plenty of fluids. Get some real rest. Stay at home to avoid the spread. Wear a mask around others in your household.

If you start wheezing and feel short of breath, Falsey said, those would be clear signs that you should see a doctor or perhaps rush to the emergency room. In the hospital, if necessary, they can give you supplemental oxygen.

There is no vaccine protection against RSV, but that may change next season. In the US, there are four RSV vaccines that may be close to FDA review, and more than a dozen are undergoing testing. Some are designed to protect children, while others are being tested on older adults.

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

We will be familiar with the protective measures for this busy RSV season: wash your hands often, disinfect surfaces and wear a mask in crowded places.

“You might 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. “Costumes and hand washing work. I know people kind of get over it, but if you’re a frail person or you know you have underlying illnesses, when we know RSV is on the rise, you should do those things and be careful around children who are actively sick. That all helps.”