Last year, cases of RSV in children and adults accelerated over the summer into the fall, raising a concern about a “Triple-demic” (COVID, Flu, & RSV).  Fortunately, for unclear reasons, RSV cases declined as winter set in. 

On July 26, 2023, AMDA presented a timely webinar on “The Unrecognized Burden of RSV in Older Adults”, which is now available at: The Unrecognized Burden of RSV in Older Adults (paltc.org).  This webinar reviewed multiple studies on RSV in adults.  These studies indicate that RSV may cause up to 20% of the cases of CAP (Community Acquired Pneumonia).  During a typical year in adults over age 65, RSV contributes to 12% of medically attended ARI’s (Acute Resp Infections), 159,000 hospitalizations, and 9,500-12,700 deaths.  This compares to Influenza’s rate of 10%, 171,000 hospitalizations, and 16,000 deaths.  Besides causing Pneumonia and exacerbations of COPD and Asthma, RSV can infect hearts and cause or exacerbate CHF.  The risk of serious illness is dramatically increased in persons with CKD, and accelerates with advancing age, similar to what we have seen with Influenza and COVID.  Six months after hospitalization, about 1/3 of patients still have significant functional losses which may include cognitive decline. 

The best test for diagnosing RSV in adults is a molecular (PCR) test on a swab of the anterior nose and throat.  Many labs are set up to perform this test at the same time as testing for COVID and Influenza.  Unfortunately, the antigen test for a RSV, which is reliable in children, is insensitive in adults and not recommended.  

Treatment in adults is supportive without an antiviral medicine approved at this time.  Preventative measures are similar to those for Influenza and RSV.  

In May, the FDA approved two vaccines for prevention of RSV for use in adults aged > 60 y/o.  Both vaccines demonstrated moderate to high efficacy for preventing serious RSV infections over 2 consecutive seasons.  Both were well tolerated with acceptable safety profiles.  However, there were rare cases of inflammatory neurologic events like Guillain Barre Syndrome.  These vaccines are approved for co-administration with the flu vaccine.  MMWR from July 21 reviews the use of these vaccines:  Use of Respiratory Syncytial Virus Vaccines in Older Adults: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023 | MMWR (cdc.gov)

More information on the use of these vaccines in our facilities will be addressed at CALTCM’s next Webinar on August 21 (Click here to register).

Now is the time to consider what you can do to reduce the risk of RSV in your facilities this winter.