When chilly weather approaches, we all know that cold and flu viruses tend to follow. So does respiratory syncytial virus (RSV). Often considered a disease seen in babies, RSV infects most of us for the first time by age 2 and can make some children seriously ill. But many people are unaware that the virus can also cause serious complications in older adults or adults with underlying health conditions.
In the winter of late 2020 into early 2021, though, there were almost no cases of RSV reported around the world. Then, in the summer of 2021, doctors were alarmed to notice the opposite: an unprecedented spike in cases for the season.
Has the COVID-19 pandemic changed the way cold-weather diseases spread? And what can we do to prevent RSV? For National RSV Awareness Month, we sat down with pediatrician Jeff Stoddard, M.D., VP of Medical Affairs for Infectious Diseases and Vaccines at the Janssen Pharmaceutical Companies of Johnson & Johnson, to learn more about what we need to know about RSV right now—including new results from a promising vaccine in development.
1.
RSV isn’t just a kids’ disease.
RSV, which causes symptoms like a runny nose, cough and fever, is best-known as a rite of passage for children (and their parents). RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in infants under 1 year of age in the United States, according to the U.S. Centers for Disease Control and Prevention. Those most at risk include babies younger than 6 months of age, infants born prematurely and those with congenital heart or lung disease. Out of every 100 children younger than 6 months of age, one to two may need to be hospitalized.
“RSV usually presents as a respiratory virus with a bad wet chest cough and can be difficult to differentiate from a cold or the flu,” explains Dr. Stoddard. Young kids are also more likely to experience wheezing. “It might not put your child in the hospital, but it will definitely disrupt your household for a few days,” he adds.
But RSV can also be very serious in older patients: It causes around 177,000 hospitalizations and 14,000 deaths annually in American adults over the age of 65, compared to around 58,000 hospitalizations in children under the age of 5, due to the fact that our immune systems become less robust as we age.
2.
Adults who are older or have underlying health conditions should be extra-cautious this year.
Why did RSV rebound this past summer after it practically disappeared last fall?
“We think the sudden rise was due to people letting their guard down after taking precautions and social distancing for over a year,” Dr. Stoddard explains. “We were all too happy to shed our masks this year and may have slacked off on hand hygiene, and that, combined with increased socializing, was the perfect mix to brew RSV.”
But the main reason may be that many of us experienced a temporary waning of immunity due to months of isolation at home and lack of exposure to the virus, increasing the pool of susceptible people.
“If you’re not exposed to RSV for 18 months and suddenly come in contact with it, then you’re more likely to get a symptomatic illness,” he explains.
In October, the company announced positive results from a study of its investigational RSV vaccine candidate in adults. Based on these results, the company is evaluating its vaccine candidate in about 23,000 adults aged 60 and older in its Phase 3 EVERGREEN study.
3.
The steps to take to prevent RSV are simple but effective.
RSV is an extremely contagious virus and often spreads through droplets that fall out of the air and sit on surfaces. This “sticky” virus then transfers to people who touch that surface. Bottom line: “RSV usually spreads via direct physical contact: Someone touches a respiratory secretion, then rubs their eyes or touches their hand or nose,” Dr. Stoddard says.
That’s why good hand hygiene is crucial to preventing the spread of RSV.
“Research shows that people who wash their hands well and frequently are much less likely to get RSV,” he stresses. Since RSV can survive for many hours on hard surfaces such as tables, it’s also important to wash them often with soap and warm water or wipe them down with disinfectants. (The good news? The virus usually lives on soft surfaces such as tissues and hands for much shorter amounts of time.)
Covering coughs and sneezes can also help to prevent the spread of RSV.
If you have respiratory symptoms and aren’t sure what’s causing them, your doctor can do nasal swabs to check for flu, COVID-19 and RSV.
4.
There’s no vaccine for RSV—yet.
In a typical year, RSV affects more than 64 million people around the globe, but there’s currently no preventive vaccine for the disease.
But Johnson & Johnson is working hard to change that.
The company is pursuing multiple avenues to reduce the serious harm caused by RSV. Potential solutions include antiviral treatments and vaccines for those most vulnerable to developing serious complications: children, adults with underlying health conditions and older adults.
In October, the company announced positive results from a study of its investigational RSV vaccine candidate in adults. Based on these results, the company is evaluating its vaccine candidate in about 23,000 adults aged 60 and older in its Phase 3 EVERGREEN study.
“Many infections in which older adults are at risk for developing severe disease—COVID-19, influenza, shingles—can be prevented to a large extent by vaccines,” says Dr. Stoddard. “This investigational vaccine could be another tool in our arsenal to help protect people.”
