William Schaffner, MD, medical director at the National Foundation for Infectious Diseases (NFID), and Patsy Stinchfield, RN, MS, CPNP, president-elect of NFID, discuss how respiratory syncytial virus (RSV) affects different age groups.
William Schaffner, MD, medical director at the National Foundation for Infectious Diseases (NFID), and Patsy Stinchfield, RN, MS, CPNP, president-elect of NFID, discuss how respiratory syncytial virus (RSV) affects both younger children and older adults.
How does respiratory syncytial virus (RSV) affect different age groups?
Stinchfield: We know in children this is largely [impactful]. Young infants can have very severe RSV and be hospitalized. We in pediatrics know we worry much about the premature baby, those babies and young children with heart disease, children with immunodeficiencies. But in fact, the data will show us that children of all ages [are affected] and especially about half will have no underlying condition. RSV can be a very severe infection in all age groups: the older individuals with heart disease as well as young children. Now, one of the things we also learned from COVID is that we have to be nuanced in how we talk about these things. For most kids, they will get RSV, they'll get it by the time they're 3 or 4 years old, it'll be a mild cold, they'll get over it. For some kids, though, it'll bring them into the hospital, it will require them to have oxygen, and then we know that some children as well as large numbers of adults do die of RSV. Like COVID, we have to get the message clear that there's a wide spectrum of how this virus can impact people both healthy and those with underlying conditions.
Schaffner: I would add to that, when health care professionals—most of us—went through our training, we learned that RSV was a pediatric virus. That's what we were told. Every pediatrician and family doctor deals with, as Patsy was saying, bronchiolitis. What we have learned or are continuing to learn over the last 15 years is that this virus, which can recurrently infect us, can also cause serious illness in older persons, and that has come as a bit of surprise. I think the infectious disease community is now well aware of these data but the average internist, if you still ask them about RSV, they'll say "RSV, oh yeah, that's that pediatric virus." Well, there have been some studies to show that, in this or that year, RSV has caused hospitalizations and deaths comparable to influenza. And this is generally under appreciated. As with influenza, it strikes people who are older and people who have underlying illnesses, particularly those who have underlying lung disease such as chronic obstructive pulmonary disease. This information is the sort of realization that we need to get out there to our fellow practitioners, so that when new therapies, monoclonal antibodies, and new vaccines come along for RSV, they will understand the magnitude of the illness that's out there that we're trying to prevent. RSV can go head to head with influenza in the amount of illness it can produce in a population.
Stinchfield: Our roundtable, even those of us who have expertise in infectious diseases, were really surprised at some of the numbers: 14,000 deaths in individuals greater than 65 years of age, over 2 million related hospitalizations in that population alone. We in pediatrics know that it is the prime admission for young children. As our call to action is emphasizing, our job one is to really make sure that health care professionals understand the magnitude of this disease and then the general public as well.