RSV: Know the Risks

What is RSV?

Respiratory Syncytial Virus (RSV) is a common and potentially dangerous respiratory virus. RSV is not a new virus, but it is often underdiagnosed in adults. RSV is a leading cause of some of the most common respiratory illnesses, like bronchiolitis and pneumonia. Not only that, RSV isn’t just a one-time thing: People can get RSV multiple times throughout their lives.


What’s Worse: RSV or Flu?

RSV can be just as dangerous as the flu. In one study of older adults in the US, the risk of hospitalization due to RSV was shown to be about twice that of the flu. In another study that looked at older adults who were hospitalized with RSV or flu, RSV led to more deaths in the first year after infection. When compared to the flu, RSV can also lead to longer hospital stays (7 or more days) with higher associated medical costs.

Signs & Symptoms

RSV can often begin with mild cold- or flu-like symptoms, but for some people, infection can lead to more serious and potentially life-threatening illnesses. Symptoms usually appear in stages—not all at once. Symptoms can include:

  1. Runny nose
  2. Coughing
  3. Sneezing
  4. Fever
  5. Wheezing
  6. Decrease in appetite

Risk factors:

A person’s immune system typically weakens as they get older. Even if you’re doing everything you can to stay healthy, you may have a harder time fighting off infections like RSV. Adults aged 60 or older are also at greater risk for serious complications from RSV. One study showed that adults aged 65 or older were 15 times more likely to be hospitalized due to RSV compared to adults aged 18 through 49 years, and two additional studies showed that up to 83% of all RSV-related deaths in the US occurred in older adults.RSV can be especially risky for older adults with certain medical conditions, like COPD, asthma, congestive heart failure, liver or kidney disease, and diabetes. RSV can also lead to the worsening of other serious conditions, like asthma, COPD, and congestive heart failure. Older adults who live in a nursing home or long-term care facility could also be at high risk of severe RSV infection.

Lung Disease

e.g. Chronic Obstructive Pulmonary Disease and Asthma

Heart Disease

e.g. Congestive Heart Failure and Coronary Artery Disease

Diabetes

Chronic Kidney or Liver Disease

Impact on your life

Being hospitalized with RSV could have a long-term impact on your health. Among older adults hospitalized with RSV in the US, 1 in 3 experienced loss of function (e.g., breathlessness, decreased ability to complete activities of daily living) up to 6 months after hospitalization, and 1 in 7 required ongoing or higher-level care after being discharged from the hospital. Even if you're not hospitalized, the impact on your daily life can be disrupted. In a survey of older adults in the US who got RSV, 80% said they didn’t feel well enough to leave their homes while sick. And since RSV is highly contagious, catching it may require you to isolate from others to avoid spreading the infection.
Worsened preexisting conditions
Reduced productivity and/or activity level
Weakened cognitive ability
Limited independence and increased length of stay in hospital

1National Institute of Allergy and Infectious Diseases. Respiratory Syncytial Virus (RSV). www.niaid.nih.gov. Updated July 7, 2022. https://www.niaid.nih.gov/diseases-conditions/respiratory-syncytial-virus-rsv

2Centers for Disease Control and Prevention. Respiratory Syncytial Virus Infection (RSV). Updated November 7, 2023. Accessed November 27, 2023. https://www.cdc.gov/rsv/index.html

3Centers for Disease Control and Prevention. Older Adults Are at High Risk for Severe RSV Illness. Updated September 2023. https://www.cdc.gov/rsv/factsheet-older-adults.pdf

4Ackerson B, Tseng HF, Sy LS, et al. Severe morbidity and mortality associated with respiratory syncytial virus versus influenza infection in hospitalized older adults. Clinical Infectious Diseases. 2018;69(2):197-203. doi:10.1093/cid/ciy991

5Lin W-H, Chiu H-C, Chen K-F, et al. Molecular detection of respiratory pathogens in community-acquired pneumonia involving adults. Journal of Microbiology, Immunology and Infection. 2022;55(5):829-837. doi:10.1016/j.jmii.2021.11.009

6Centers for Disease Control and Prevention. About RSV: Symptoms and Care. Updated September 6, 2023. https://www.cdc.gov/rsv/about/symptoms.html

7Centers for Disease Control and Prevention. About RSV: Transmission. Published April 26, 2023. https://www.cdc.gov/rsv/about/transmission.html

8Widmer K, Zhu Y, Williams JV, Griffin MR, Edwards KM, Talbot HK. Rates of hospitalizations for respiratory syncytial virus, human metapneumovirus, and influenza virus in older adults. The Journal of Infectious Diseases. 2012;206(1):56-62. doi:10.1093/infdis/jis309

9American Lung Association. RSV in Adults. Published February 20, 2024. https://www.lung.org/lung-health-diseases/lung-disease-lookup/rsv/rsv-in-adults

10National Foundation for Infectious Diseases. Respiratory Syncytial Virus (RSV). Published January 2024. https://www.nfid.org/infectious-disease/rsv/

11Matias G, Taylor R, Haguinet F, Schuck‐Paim C, Lustig R, Shinde V. Estimates of mortality attributable to influenza and RSV in the United States during 1997-2009 by influenza type or subtype, age, cause of death, and risk status. Influenza and Other Respiratory Viruses. 2014;8(5):507-515. doi:10.1111/irv.12258

12Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289(2):179. doi:10.1001/jama.289.2.179

13Savic M, Penders Y, Shi T, Branche A, Pirçon J. Respiratory syncytial virus disease burden in adults aged 60 years and older in high‐income countries: A systematic literature review and meta‐analysis. Influenza and Other Respiratory Viruses. 2022;17(1). doi:10.1111/irv.13031

14Branche AR, Saiman L, Walsh EE, et al. Change in functional status associated with respiratory syncytial virus infection in hospitalized older adults. Influenza and Other Respiratory Viruses. 2022;16(6):1151-1160. doi:10.1111/irv.13043

15Linder KA, Malani PN. RSV infection in older adults. JAMA. 2023;330(12):1200. doi:10.1001/jama.2023.16932

16Curran, D. et al. (2022) ‘Impact of respiratory syncytial virus disease on quality of life in adults aged ≥50 years: A qualitative patient experience cross‐sectional study’, Influenza and Other Respiratory Viruses, 16(3), pp. 462–473. doi:10.1111/irv.12929

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