As Covid-19 cases rise in many parts of the country, another virus is also surging. Respiratory syncytial virus, or RSV, is causing an increased number of emergency department visits and hospitalizations in Florida and other southeastern states, and will likely begin to impact the rest of the nation in the coming weeks. The spike in RSV cases prompted the Centers for Disease Control and Prevention (CDC) to issue a health alert this week, recommending clinicians and caregivers be on the lookout for patients with symptoms suggestive of RSV.
What Is Respiratory Syncytial Virus?
RSV is an RNA virus that was first discovered in the 1950s, and has long been recognized as a significant cause of respiratory illness in young children. In fact, RSV is the most common cause of bronchiolitis (i.e., inflammation of the small passages in the lungs) among children less than one year of age, and results in nearly 60,000 children being hospitalized in the United States each year. Worldwide, it’s estimated to infect 64 million people and cause 160,000 deaths annually.
In most cases, symptoms are generally mild and include a runny nose, cough, mild headache and mild fever. However, in young children, the elderly and those who are immunocompromised, symptoms can be severe and involve wheezing, a significant cough and respiratory distress.
What Can Be Done To Treat Or Prevent Disease?
Similar to Covid-19, RSV is typically spread through respiratory droplets that are produced when an infected person coughs or sneezes. For years, the best means of protection from RSV was good hand hygiene, as well as covering your mouth or nose when coughing and sneezing. During the Covid-19 pandemic, the rates of RSV plummeted, likely due to a combination of factors, including social distancing, masking and reduced travel. However, as pandemic precautions have lifted, the incidence of RSV has increased and will likely return to a typical seasonal pattern, where cases surge in the fall and winter months in the norther hemisphere. Fortunately, in 2023, several new tools have been approved by the Food and Drug Administration (FDA) to prevent severe disease resulting from RSV infection.
The first is a monoclonal antibody, called nirsevimab, which is given by intramuscular infection and is recommended by the CDC for all infants less than eight months of age. The immunization is also recommended for children eight to 19 months of age who are immunocompromised or at risk for severe disease. Clinical trials showed nirsevimab to provide protection for at least 5 months and reduce the incidence of hospitalization and healthcare visits among infected infants by 80%.
Several new RSV vaccines have also received FDA approval. For adults 60 years of age and older, two recombinant protein vaccines (RSVPreF3 and RSVpreF) are now available and have been shown to be more than 80% effective in preventing lower respiratory disease. On August 21, 2023, RSVpreF was approved by the FDA for pregnant women during weeks 32 through 36 of gestation. Infants born to vaccinated mothers demonstrated significant rates of protection from severe, lower respiratory tract disease for at least 6 months following birth.
These new tools represent a revolutionary advancement in our fight against a virus that has historically killed nearly 15,000 people each year in the United States.
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