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Respiratory Syncytial Virus: Assessing Adult Morbidity & Mortality

Respiratory Syncytial Virus: Assessing Adult Morbidity & Mortality

More than 60 years ago, respiratory syncytial virus (RSV) was first recognized as a cause of bronchiolitis in infants. “RSV has long been thought of as a significant cause of lower respiratory tract infections in young children, but more recent studies indicate that the virus is a potentially serious problem in older adults,” says D. Jane Hata, PhD. Research indicates that RSV outbreaks occurred in long-term care facilities in the 1970s. Since that time, additional studies in hospitalized adults have suggested that RSV may be an important cause of illness among community-dwelling elderly people. Recent estimates of the disease burden of RSV in adults have been based on mathematical models linking viral activity in children with hospitalization and death in adults. According to published research, RSV accounts for approximately 10,000 deaths each year in the United States among people aged 65 or older. Although these estimates are useful, their accuracy is questionable because of the circulation of other respiratory viruses that have clinical symptoms that are indistinguishable from RSV.   Taking a Closer Look Previous studies have shown that morbidity and mortality rates for adult patients with RSV are high. In an effort to examine this phenomenon more thoroughly, Dr. Hata and colleagues had a study published in Diagnostic Microbiology & Infectious Disease in which they retrospectively reviewed 2-year chart data at multiple centers on 334 patients who tested positive for RSV. They then analyzed indicators of morbidity and mortality in children younger than 6 years old, in adults who were immunocompetent and immunosuppressed, and in transplant patients. “Our results showed that several groups of adults with RSV experienced...
Managing Adult Respiratory Syncytial Virus

Managing Adult Respiratory Syncytial Virus

While it is often thought of as a disease in children, respiratory syncytial virus (RSV) infections cause significant illness and death in older adults every year. Clinicians are urged to learn more about the illness and death caused by RSV in these patients and to develop protocols in anticipation of vaccinations against the virus. Respiratory syncytial virus (RSV) infections can cause a variety of respiratory illnesses, such as bronchiolitis and pneumonia. In addition to infants and young children, symptomatic RSV infections can occur in adults. The infection usually lasts less than 5 days in healthy adults, and symptoms are often consistent with upper respiratory tract infections. These include runny nose, cough, headache, fatigue, and fever. High-risk adults, such as those with certain chronic illnesses (like congestive heart failure or COPD) or weakened immune systems, may have more severe symptoms with lower respiratory tract involvement. Although people of any age can be infected with RSV, recent data estimate that the virus  commonly impacts older patients, accounting for approximately 177,000 hospitalizations and 14,000 deaths each year among adults older than age 65. “Studies have found that RSV infection is a significant cause of illness and death in older adults,” says Lindsay Kim, MD, MPH. Modeling studies have also suggested that RSV in older adults occurs with incidence and mortality rates similar to seasonal influenza. In the United States, RSV infections generally occur during the fall, winter, and spring.   A Challenging Diagnosis Since RSV has signs and symptoms that are similar to other viruses, it can be difficult to diagnose RSV in older adults, says Dr. Kim (Table). “As we learn...
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