RSV: What it is and how to prevent it
10/19/2020 by Robert M. Jacobson, M.D., Julie Gebel, R.N., and Debra Goodew, R.N.
Anyone can get RSV, which stands for respiratory syncytial virus. It can cause coughs, cold-like symptoms and fever, and lead to ear, sinus, eye and lung infections. Almost all children get infected at least once by two years of age. Most of us continue to get re-infections from RSV the rest of our lives.
What's the risk?
RSV infections occur most commonly in winter. In Minnesota, they start as early as November and run through April. RSV may be responsible for as many as 25% of wintertime deaths once blamed on influenza (flu).
The Centers for Disease Control and Prevention (CDC) reports each year that RSV results in 2 million outpatient visits and 50,000 hospitalizations among U.S. children under five years of age. RSV causes nearly 180,000 hospitalizations and 14,000 deaths among U.S. adults 65 years and older.
How does RSV affect us?
How RSV affects you depends on your age and whether you've had it before.
- In infants and young children, RSV causes a wheezy type of lung infection (bronchiolitis). Patients look and sound like they're having an asthma attack. Unlike asthma, infants with bronchiolitis don't respond to asthma medicines, such as albuterol and corticosteroids.
- Premature infants, as well as full-term infants with underlying health conditions, may need to go to the hospital due to RSV. There, doctors and nurses can support them with intravenous fluids and oxygen until they recover.
- RSV is particularly bad for older adults and those whose immune systems are weakened by medicines or disease.
No matter the age, during this COVID-19 pandemic, respiratory illnesses may require testing to rule out COVID-19 infections. If we do not test, we may let individuals with COVID-19 go undetected and unknown. These individuals can spread the infection to others in their household and community.
Is there a vaccine against RSV?
We don't have a vaccine to prevent RSV. We do have a treatment that gives temporary immunity. Palivizumab (Synagis®) is given as an intramuscular injection once a month. High-risk babies get palivizumab from November through March. The treatment reduces the risk of hospitalization from RSV, but it hasn't been shown to prevent deaths.
What can we do to prevent RSV infection?
There are some things you and your family can do:
- Avoid exposure to tobacco and other smoke.
- If possible, keep infants at high risk from daycare during the RSV season.
- Wash hands in all settings.
Masking, handwashing, social distancing, and avoiding crowds will reduce your exposure to RSV as it will COVID-19. If you're ill with what seems like RSV, stay home until your fever is gone for 24 hours, cover your cough (into the inside of your elbow) and wash your hands. Most people are infectious for three to eight days; infants can be infectious for a month. Furthermore, now during the pandemic, consider getting tested for COVID-19.
Who should get tested for COVID-19?
- People who have symptoms of COVID-19 such as the cough or fever that RSV can cause. Not everyone needs testing but call your care team or use the CDC self-checker to determine if you need testing.
- People who have had close contact (within 6 feet of an infected person for at least 15 minutes) with someone with confirmed COVID-19.
- People who have been asked or referred to get testing by their healthcare provider, local public health official, or state health department.
If you do get tested, you should self-quarantine/isolate at home pending test results and follow the advice of your health care provider or a public health professional.
Dr. Robert M. Jacobson is the medical director of the Primary Care Immunization Program for Primary Care in Southeast Minnesota.
Julie Gebel is a registered nurse and is the program coordinator of the Primary Care Immunization Program for Primary Care in Southeast Minnesota covering Rochester and Kasson.
Debra Goodew is a registered nurse and is the program coordinator of the Primary Care Immunization Program for Primary Care in Southeast Minnesota covering the rest of the Southeast Minnesota region.