RSV Season Hits Adults Harder Than Expected
The respiratory virus season has started early in kids this year, flooding children’s hospitals in many parts of the country – especially with respiratory syncytial virus, known as RSV. But adults can get RSV too, and the virus can be serious and even deadly for seniors and people with underlying health conditions.
According to data from the US Centers for Disease Control and Prevention, about 6 out of every 100,000 seniors have been hospitalized with RSV this season. That’s significantly lower than the rate for children but still uncharacteristically high. In the years before the Covid-19 pandemic, hospitalization rates for seniors were about 10 times lower at this point in the season.
Dr. Ann Falsey, a professor of infectious diseases at the University of Rochester Medical Center, said RSV rose somewhat in children in the summer and early fall last year, but the US did not see the usual proportional increase in RSV in older adults at the time. ‘I think that older adults were more cautious to continue public health measures like masks and social distance last year because they were still worrying about Covid,’ she said. ‘But this year, we’re starting to see older people ending up in the hospital again with RSV, because everyone is throwing caution to the wind.’
Too often, RSV flies under the radar in adults, Falsey said. Many people, even doctors, overlook its impact on adults. ‘They think of it as strictly a pediatric disease, but you know, if you don’t test for it, you’ll never know what somebody actually is sick with,’ she said.
RSV can be a serious disease for adults, especially those 65 and older. The virus can lead to dehydration, breathing trouble, and more serious illnesses such as pneumonia and bronchiolitis, inflammation of the tiny airways in the lungs. Adults with weakened immune systems, such as those undergoing treatment for cancer, transplant patients, people with HIV, and those who take certain drugs that suppress the immune system, are also at higher risk for severe outcomes with RSV.
According to Falsey, there are between 10,000 and 15,000 adult deaths in the United States from RSV each year and around 150,000 hospitalizations for RSV. A 2015 study of older adults in industrialized countries calculated that about 14.5% of the 1.5 million adults who caught RSV were admitted to hospitals. People who were 65 and older were more likely to be hospitalized than those ages 50 to 64.
RSV shows up in adults the same way it does in kids. It can look like a common cold and include runny nose, decreased appetite, coughing, sneezing, fever, and wheezing. The symptoms typically last a week or two, and they clear up with rest and fluids. But in some adults, RSV can become dangerous because it can lead to dehydration, breathing trouble, and more serious illnesses such as pneumonia and bronchiolitis.
The adults who are most seriously at risk for severe outcomes with RSV are those 65 and older. The virus can spread quickly through a nursing home or long-term care facility, just like Covid-19 and flu. Adults with chronic heart or lung disease, such as asthma, COPD, or heart failure, are also more likely to have to go to the hospital if they catch RSV.
RSV can easily spread from children to adults, too. If you have been coughing or have any other RSV-like symptoms and you are in a high-risk category, you should go to your doctor and get it checked out, says Dr. Daphne-Dominique Villanueva. ‘We can’t test everybody right now – in an ideal world we would want to do that – but we want to concentrate on vulnerable people,’ she said.
Doctors’ offices have swab tests that can determine whether an illness is flu, RSV, or Covid. Treatment approved in Europe to prevent RSV in infants could be coming to the US soon. There are specific antivirals for flu and Covid-19 but not for RSV. The trick is getting tested early, even to rule out RSV; getting started on Covid or flu antivirals right away can shorten the time you are sick and keep the virus from progressing to something more serious.
With RSV, the treatment is what’s called supportive care: Drink plenty of fluids. Get some 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 take yourself to an emergency room quickly. At the hospital, they can give you supplemental oxygen if necessary.
Protective measures for this busy RSV season will sound familiar: Wash your hands frequently, disinfect surfaces, and wear a mask in crowded spaces. ‘Masks and hand-washing work,’ Falsey said. ‘I know people are kind of over it, but if you’re a frail person or you know you have underlying medical conditions, when we know that RSV is surging, you should do those things and use caution around children who are actively sick. It all helps.’
