RSV Season Hits Adults Hard

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. Although RSV does not typically send as many adults to the hospital, it can be a serious and even deadly disease for seniors and people with underlying health conditions.

And with more kids getting RSV, the chances that adults will be exposed also rise. Some doctors say they are starting to see an uptick in adult patients.

RSV in Seniors: A Growing Concern

This season, about 6 out of every 100,000 seniors has been hospitalized with RSV, according to data from the US Centers for Disease Control and Prevention. 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 who has published research on RSV in adults, 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,” Falsey 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.”

The Impact of RSV on Adults

Too often, RSV flies under the radar in adults, she 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,” Falsey said.

In the United States, tracking viruses like RSV isn’t nearly as thorough as it is for Covid-19, so it is difficult to know exactly how many adults get sick with RSV. The numbers of RSV cases come from self-reports that go to a few dozen labs that only represent about a tenth of the population, and reports are then shared with the CDC.

Flu and other respiratory virus activity continues to ramp up across the US.

RSV Symptoms in Adults

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, inflammation of the tiny airways in the lungs.

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 weakened immune systems need to be careful in RSV season. This can include people undergoing treatment for cancer, transplant patients, people with HIV, and those who take certain drugs that suppress the immune system for diseases like Crohn’s, lupus, or rheumatoid arthritis.

Adults with chronic heart or lung disease like asthma, COPD, or heart failure are also more likely to have to go to the hospital if they catch RSV.

Preventing RSV

There’s no protection from a vaccine for RSV, but that could change by next season. In the US, there are four RSV vaccines that may be nearing review by the FDA, and more than a dozen are going through trials. Some are designed to protect infants, and some are being tested in older adults.

“Since we have very limited ways of treating it effectively, you should do whatever you can to prevent getting it in the first place,” said Dr. Daphne-Dominique Villanueva, an assistant professor in the School of Medicine at West Virginia University who has written studies about RSV.

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 put off that visit for a week to see your grandkids, or you might want to wear a mask if you are going into a crowded place,” Falsey said. “Masks and hand-washing work. 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.”