What is Respiratory Syncytial Virus? Doctors explain lesser-known virus

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MANILA, Philippines — Respiratory Syncytial Virus (RSV) is a common, contagious virus affecting the lungs and breathing passages.

It usually causes mild, cold-like symptoms that are often mistaken for other respiratory pathogens. Sometimes regarded as a pediatric illness because it affects children with weak immune systems, it actually affects adults just the same, especially those with certain underlying conditions, and the dangers that it poses seriously increase in seniors with comorbidities, immune-compromised status, or advanced age.

Older adults suffering from such conditions may experience severe infections, as RSV can exacerbate conditions, such as Chronic Obstructive Pulmonary Disease (COPD), asthma and chronic heart failure. It can lead to severe outcomes that include pneumonia, hospitalization, and, in extreme cases, death.

Statistics show that each year, approximately 177,000 adults aged 65 and above are hospitalized in the United States due to RSV, and an estimated 14,000 cases result in death.

According to the Philippine Statistics Authority, the Philippines has over 9 million seniors aged 60 and above. Public health officials are warning seniors, especially those with comorbidities, that they are at high risk for severe RSV infections due to weakened immune systems and have to be extra careful and vigilant in guarding their health.

Dr. Rontgene Solante, an Infectious Disease Expert and President of the Philippine College of Physicians, describes RSV as a widespread yet lesser-known respiratory virus that transmits through inhalation or contact with respiratory secretions of those infected. It typically manifests symptoms, such as congestion, cough, wheezing, and low-grade fever.

"Identifying RSV from other respiratory diseases is difficult because of its non-specific symptoms similar to other illnesses. Diagnosis requires testing that is often expensive and not widely accessible. Seniors and individuals with comorbidities may mistake their symptoms for a common cold or flu, not realizing they could be suffering from RSV, which can result in severe long-term damage or even fatal complications. More concerning is that there is no specific treatment for RSV in adults,” Dr. Solante said.

He emphasized that while RSV can infect individuals at any time of the year, it spreads more intensively during the rainy months, from September to February, peaking in the colder months of October and December. This highly contagious virus spreads easily within households, where one infected person typically infects three others, and while most are infectious for three to five days, older adults may transmit the virus for extended periods.

“Our seniors are particularly susceptible and vulnerable because, in Philippine culture, they often live with family members who also serve as their caregivers. These family members may unknowingly contract RSV at work or elsewhere and bring it home to their senior relatives. Within the household, symptoms might be dismissed as just the flu, not realizing that what’s circulating is RSV, which can be fatal for seniors," the doctor added. 

Greater burden on older people

Dr. Lourdes Dumlao, President of the Philippine College of Geriatric Medicine, observed that RSV is often depicted as a pediatric illness on social media because children, like seniors, have weak immune systems, making them vulnerable. However, she emphasized that RSV presents a greater burden on seniors.

Dr. Dumlao explained: “Studies have shown that the incidence of hospitalizations and mortality due to RSV is substantially higher in seniors than in children. Seniors with certain underlying conditions, such as pneumonia, congestive heart failure (CHF), asthma, and chronic obstructive pulmonary disease are at higher risk of hospitalization when infected with RSV. Additionally, RSV can cause various severe respiratory complications in older adults, including arrest and failure, respiratory distress, and emphysema. Further, about 30% of older adults may develop heart complications when hospitalized with RSV.”

Dr. Lenora C. Fernandez, head of Pulmonary Services at Asian Hospital and Medical Center and former President of the Philippine College of Chest Physicians, highlighted the extensive aftercare needed by RSV patients even after hospital discharge, stressing the burden this imposes not only on the patients themselves but also on their families.

"One out of four RSV patients (24.5%) may require professional home care after hospital discharge. Additionally, up to one out of four (26.6%) of these patients are readmitted within three months post-discharge, and even more concerning, three out of 10 (33%) may die from complications related to RSV within a year of their initial admission,” Dr. Fernandez said. 

Proactive health measures 

Dr. Solante emphasized the importance of education in mitigating the health risks of RSV and highlights the need for both seniors and their caregivers to be well-informed.

"RSV is difficult to detect and prone to misinformation so I advise seniors to discuss RSV with their doctors who can guide them on the necessary precautions to reduce their health risk," he advised.

Dr. Fernandez suggested immediate action if flu-like symptoms appear within the household. "I recommend that families implement safety and hygiene protocols promptly to protect their seniors, such as isolating symptomatic individuals, wearing face masks, and engaging in frequent handwashing,” she added.

Dr. Dumlao reinforced the timeless advice that prevention is better than cure.

"Seniors must be proactive about their health," she stated. "Through regular medical consultations, seniors can ensure that they receive the right interventions to mitigate RSV risks, while also adopting healthy habits like maintaining a healthy diet, getting adequate sleep, and engaging in regular exercise to boost their immune system."

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