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RSV: Respiratory Syncytial Virus

RSV is a respiratory virus that causes significant illness and death, particularly for babies under 6 months and adults older than 60.

Each year, RSV sends up to 80,000 kids under 5 to the hospital. For adults over 65, as many as 160,000 hospitalizations are attributed to RSV. So, although we often think of this as a disease affecting children, it has devasting effects on our older population, too.

The good news is that there have been several recent approvals of RSV vaccines, which may mean new treatments and less illness for the cold and flu season. The University of Kansas Health System is part of an academic medical center that’s connected to ongoing research, including data on the control and spread of respiratory viruses. We’re always working to provide our patients access to the best preventive care and treatment.

What is RSV?

RSV is a virus that affects your lungs and breathing. While you can get RSV at any time, it is more common to get it in the winter months, like getting the flu.

For most people, RSV is a mild virus that’s similar to the common cold. However, for the very young, older adults and those with other risk factors, RSV can lead to bronchiolitis, pneumonia, hospitalization and death.

Jessica Lovell:
Big news from the FDA yesterday. It approved the first ever vaccine for RSV. We knew this would be coming. The shots should be ready for adults 60 and over sometime this fall. The vaccine is for seniors, but we usually think of RSV as a pediatric problem. We know it can affect people in the older age groups, but what should we know about this and do we think it might be coming for the young ones as well?

Dana Hawkinson, M.D.:
Yeah, so again, RSV is a respiratory virus. It does have some seasonality to it, again like most of the other respiratory viruses. But it does cause significant morbidity and mortality, so illness and death, not only for those young patients, especially those under six months, but also those older patients, those older than 60 or 65. So in any one year, you can have 60,000 to 120,000 hospitalizations in people over 65, and you can also have up to 6,000 to 10,000 deaths in those over 65 as well. This new vaccine is old technology. It is a protein-based vaccine, but it is safe and effective against preventing hospitalization and death. It's about 84% effective at preventing lower respiratory tract disease, which can lead to hospitalization and about 90% to 94% at preventing death in those over 60.

So this is approved for those over 60. Now we just have to wait to see if the CDC recommends it, which we do anticipate. Those meetings I believe will be in later June, and then hopefully it will be available for use in the next coming respiratory viral season. We also do anticipate another adult vaccine for RSV being approved and recommended. And then finally, we are waiting for a children's vaccine, which is actually given to pregnant mothers and then they are able to confer immunity to baby, but also a new monoclonal antibody treatment for pediatric patients as well. So it's really exciting as far as RSV goes, a lot of prevention and treatment coming down the pike, we hope.

Jessica Lovell:
Nothing excites you more than the approval of a new vaccine, right Doc Hawk?

Dana Hawkinson, M.D.:
Yeah, I mean we're always in a war with our environment around us and these are things that we can do to help keep us safe and well.

Jessica Lovell:
All right. Thanks for reporting that good news for us today.

Types of RSV

There is a type A RSV and a type B, but they are not substantially different in their symptoms or severity.

RSV symptoms and risks

The symptoms of RSV often mimic the common cold:

  • Congestion and runny nose
  • Cough
  • Fatigue
  • Fever
  • Loss of appetite

However, RSV frequently causes wheezing and shortness of breath, which are causes for concern.

If you have a premature infant or baby under 6 months old, they may be at risk for RSV since their immune system is underdeveloped. Similarly, if you’re over 65, you may have age-related decline in your immunity that makes you more susceptible to RSV.

You’re also more at risk for getting RSV if you have chronic obstructive pulmonary disease (COPD) or asthma.

RSV diagnosis and screening

If you are feeling sick and have RSV symptoms, visit your primary care doctor or an urgent care. At the visit, your doctor will start with a physical exam. If needed, they may order a test – usually a nasal swab – to confirm RSV.

RSV treatment

The first step in treating RSV is to get lots of fluids, rest and take pain relievers or fever-reducing medications.

In more severe cases, you may need IV fluids or additional oxygen. In the most extreme cases, intubation may be required to help you breathe.

RSV prevention

There have been several recent developments aimed at preventing the spread of RSV in the first place. The Food and Drug Administration has granted approvals for 3 different vaccines – 2 for adults over 60 and 1 for young children with specific medical conditions. These vaccines could be available in late 2023.

Additionally, it’s always a good idea to limit your contact with sick people, wash your hands frequently and avoid touching your face to avoid catching RSV.

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