Red Alert: Silent virus threatening winter

In October 2022, respiratory infections led to an increase in calls to emergency services.¹, a scenario that could repeat itself this year, as the latest indicators show. In severe cases, these infections can lead to serious consequences or even death².

Joana Louro, a specialist in internal medicine, attended Manhã CM to talk about respiratory syncytial virus (RSV), leaving several warnings. Watch the video:

Triple epidemic

The combination of COVID-19, influenza and RSV, with a simultaneous increase in cases of three pathologies, has had an unexpected impact in 2022.³. As a result of these viruses may increase hospitalizations and deaths – Older people and people with underlying health conditions are particularly at risk for severe outcomes⁴ – leaving hospitals and health systems under pressure in many countries, including Portugal.⁵.

If infected with RSV, people with chronic diseases such as asthma, diabetes, chronic obstructive pulmonary disease (COPD) and heart disease carry an increased risk of hospitalization. and are therefore even more susceptible to serious consequences^6.7.

What is respiratory syncytial virus?

RSV, very contagiousis a seasonal virus that circulates mainly in autumn and winter in temperate climates.⁹. This virus usually causes mild, cold-like symptoms.¹⁰. However, RSV is an important cause of respiratory disease^eleven.

What is the clinical impact of RSV?

The disease affects people of all ages, mainly affecting infants, children and adults with risk factors.¹². Let’s highlight some important data:

• Most children under two years of age have RSV infection, and the virus is the leading cause of acute lower respiratory tract infection in infants.^13.14.

• Adults 60 years of age and older and those with certain underlying medical conditions are at increased risk of serious RSV infection, which can lead to hospitalization.¹⁵ and the consequences can be serious^16.17which affects their functional state and quality of life in the long term¹⁸.

How is it transmitted?

RSV spreads easily through coughing and sneezingsurvives for several hours on hands and hard surfaces, which is very common in a family context.^19,20,21. Transmission of the infection can occur through direct or indirect contact with nasal or oral secretions from infected people.²⁰. Typically, infected people are contagious for three to eight days.¹⁹.

What are the symptoms?

The symptoms are very similar to those of other respiratory infections.²² and include, but are not limited to, fever, cough, and sore throat, the severity of which varies depending on the age and health of the individual.²³.

What complications can there be?

RSV infection is associated with the development of bronchiolitis, tracheobronchitis and viral pneumonia.²³. And it can worsen chronic diseases such as COPD, asthma or congestive heart failure.^23,24,25.

Can RSV infection be cured?

There is no specific treatment for RSV infection in adults.²⁶. Standard treatment for acute infection includes supportive care and hydration.^26.27.

And can this be prevented?

The risk of RSV transmission can be reduced by simple preventive measures such as hand washing, cleaning surfaces frequently, and avoiding close contact with sick people.

Remember that transmission can occur, as we mentioned above, through contact with contaminated surfaces, but primarily through direct physical contact with an infected person – the most important form of transmission.

So, People with symptoms similar to the common cold should not interact with high-risk children and adults.including premature babies, children under two years of age with chronic lung or heart disease, and children and adults age 60 and older with weakened immune systems.

Respiratory syncytial virus poses a hidden threat, especially for at-risk groups. Information and prevention are critical to mitigating the impact of this seasonal epidemic. Consult your doctor for specific instructions and pay attention to basic hygiene measures to protect yourself and others.

This content was developed with support from GSK. For more information, consult your doctor.

NP-PT-AVU-BRF-230004 | 11/2023

References:

1. https://www.cmjornal.pt/sociedade/detalhe/urgencias-cheias-com-aproximar-do-inverno

two. https://www.chln.min-saude.pt/wp-content/uploads/2023/01/i029916.pdf

3. https://www.cmjornal.pt/sociedade/detalhe/caos-nas-urgencias-com-espera-de-14-horas

4. Centers for Disease Control and Prevention (CDC), 2023. RSV in older adults and adults with chronic diseases. https://www.cdc.gov/rsv/high-risk/older-adults.html [Consultado em agosto de 2023].

5. https://www.sabado.pt/ciencia—saude/detalhe/portugal-infecoes-respiratorias-atingem-numeros-recorde-e-aumentam-pressao-no-sns

6. Savich M., Penders Y., Shi T., Branchet A., Pearson J.Y. Burden of respiratory syncytial virus disease in adults aged 60 years and older in high-income countries: a systematic literature review and meta-analysis. Influenza Other respiratory viruses 2021 November 11

7. Branch A.R., Sayman L., Walsh E.E., Falsey A.R., Seeling W.D., Grindyke V., Peterson D.R., Vargas S.I., Phillips M., Finelli L. Incidence of respiratory syncytial virus infection among hospitalized adults, 2017–2020. Wedge Infectious Dis. 2022 March 23;74(6)

8. Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Research work. The epidemiology of multimorbidity and its implications for healthcare, research and medical education: a cross-sectional study The Lancet online

9. Bloom-Feshbach K et al. PLoS One 2013;8:e54445.

10. Centers for Disease Control and Prevention (CDC), 2022. RSV in older adults and adults with chronic diseases. https://www.cdc.gov/rsv/high-risk/older-adults.html.

11. Battles M.B., McLellan J.S. Nat Rev Microbiol 2019;17:233–245

12. Openshaw P.J.M. et al Annu Rev Immunol 2017;35:501–532;

13. Nair H et al. Lancet 2010;375:1545–1555.

14. Centers for Disease Control and Prevention (CDC), 2022. Respiratory syncytial virus (RSV) infection: symptoms and care. http://www.cdc.gov/rsv/about/symptoms.html

15. Savic M et al. Other respiratory influenza viruses 2023;17(1):e13031

16. Centers for Disease Control and Prevention (CDC), 2012. RSV in older adults and adults with chronic diseases. https://www.cdc.gov/rsv/high-risk/older-adults.html

17. Branch A.R. et al. Clin Infect Dis 2022;74(6):1004-1011

18. Curran D et al. Other Respiratory Influenza Viruses 2022;16:462–473

19. Griffiths S et al. Clin Microbiol Ed. 2016; 30: 277–319.

20. Heikkinen T. and others. Open Infect Dis forum 2015;2:ofu118

21. Kulkarni H et al. Am J Respir Crit Care Med 2016; 194:308–316

22. Kodama F et al. Infect Dis Clin North Am 2017; 31: 767–790

23. National Health Service (SNS24). Infectious diseases. Respiratory syncytial virus. https://www.sns24.gov.pt/tema/doencas-infecciosas/virus-sincicial-respiratorio/#

24. Folsey A.R. et al N Engl J Med 2005;352:1749–1759

25. Centers for Disease Control and Prevention (CDC), 2022. RSV in older adults and adults with chronic diseases. https://www.cdc.gov/rsv/high-risk/older-adults.html

26. Centers for Disease Control and Prevention (CDC), 2022. RSV – Symptoms and Care. https://www.cdc.gov/rsv/about/symptoms.html

27. Smith D.K. et al. Am Fam Physician 2017; 95:94–99.