Understanding the Threat of Respiratory Syncytial Virus in Adults

by Dr. Jon Avery Go

Respiratory Syncytial Virus (RSV) is a contagious respiratory virus that primarily affects infants, young children, and the elderly.

RSV positivity rates have shown significant seasonal variations, with outbreaks typically starting as early as October, peaking in January to February, and lasting until May.

It is the third most commonly identified virus that causes respiratory hospitalizations. The virus spreads through inhaled droplets when an infected person coughs or sneezes, infecting the respiratory tract. It can survive on surfaces for hours, making it highly transmissible.

Most adults who are symptomatic for RSV develop upper respiratory tract infection symptoms 3-5 days after being infected, and symptoms can range from mild to severe.

Common symptoms include congestion, runny nose, coughing, sore throat, wheezing, fever, decreased appetite, and difficulty breathing. Severe cases can lead to pneumonia, respiratory failure, and acute cardiac events.

It is challenging to distinguish RSV from influenza, COVID-19, and other respiratory-borne illnesses.

Treatment for RSV is mostly supportive care for recovery. Over-the-counter fever reducers and pain relievers work well along with hydration and rest.

Antiviral therapy is reserved for those who are severely immunocompromised in an inpatient setting.

Preventing RSV involves good hygiene practices such as frequent hand washing, disinfecting surfaces, and avoiding close contact with infected individuals.

The CDC recommends that all adults aged 75 and older receive a single dose of the RSV vaccine.

It is also recommended for adults 60-74 years old who are at increased risk for developing severe disease.

This includes people who have severe comorbidities such as cardiovascular disease, chronic lung disease, chronic liver disease, end stage renal disease, certain neurologic conditions, diabetes with complications and severe obesity.

This also includes transplant patients, those undergoing chemotherapy (especially for leukemia or lymphoma), taking long-term immunosuppressants, and the frail and elderly living in long-term care facilities.

No booster dose has been recommended at this time.

Preventive measures, including hand hygiene, avoiding close contact with sick individuals, and vaccination, are essential in reducing the spread of RSV in the community.

DR. JON AVERY GO is a board-certified Internal Medicine physician. He practices as a primary care doctor at Primary Care Clinic of Hawaii.