What is important to know about respiratory syncytial virus

Respiratory syncytial virus (RSV) is a common respiratory virus that usually causes mild cold symptoms. Although most people recover within a week or two, RSV can also cause severe illness, especially in infants, the elderly, and patients with chronic conditions. Currently, the number of GP visits and hospitalizations for RSV-related cases has increased, so it is worth finding out more about this virus.

Residents are suffering from the flu, there may also be an increase in the number of Covid-19 patients, but children with another respiratory syncytial virus (RSV) are being admitted to the reception department of the children’s hospital.

“We feel a significant increase in visitors at the pharmacy as well,” confirms Juta Namsone, a pharmacist at “Mēnes aptiekas”. “People ask for cold remedies, especially for children. That is why we are trying to increase knowledge about RSV and pass it on to parents of children.” The specialist adds that a special group of visitors are seniors who deserve special attention and care, and RSV can also be a dangerous virus for them. This means that every elderly visitor who needs, for example, “something for a runny nose”, should also be discussed about what to do if the disease caused by a virus worsens, should be encouraged to contact a doctor, possibly to perform tests.

“Central Laboratory” doctor Jana Osīte also emphasizes the importance of tests: “Laboratory tests are the basis of the diagnosis of almost all diseases, and the more accurate the diagnosis, the more targeted treatment is possible. Currently, the incidence of acute upper respiratory tract infection symptoms is increasing in all age groups, and it must be recognized that influenza is a particularly contagious viral infection – it spreads easily from person to person. Symptoms of acute upper respiratory infections are similar. In order to distinguish which viral infection is the cause of the illness, laboratory testing is essential. Testing for several viral infections (influenza A and B, respiratory syncytial virus and Covid-19) can be performed at the same time. It only requires a nasopharyngeal swab and results are available within 12-24 hours.”

The RSV season started earlier this year

“The timing and severity of RSV outbreaks can vary geographically and seasonally. RSV usually starts in late autumn and reaches its peak in winter,” says family doctor Linda Šauriņa. “But this year, in many parts of the world and also in Latvia, RSV and flu started earlier and are still going on, besides, Covid-19 is circulating at the same time, and thus the risk of getting sick has tripled.” The doctor admits that the complete abandonment of disease-limiting measures, including masks, is also to blame, allowing viruses to spread freely.

Awareness of the level of risk

Infants younger than 6 months of age, especially those born prematurely, are at greatest risk of complications from severe RSV infections. The second risk group is people aged 65 and older. RSV is especially dangerous for those with underlying medical conditions, including heart or lung problems, as well as a weakened immune system, such as a recent bout with covid or the flu.

The highest RSV hospitalization rates in children are in the first months of life. It is especially dangerous in the newborn period up to the age of one month. Most of the hospitalized children are under the age of two.

In older adults, RSV is a common cause of severe respiratory disease. RSV infections in adults can cause acute myocardial infarction, stroke, exacerbate asthma, and chronic heart and lung disease, or COPD. Rates of RSV infection in patients with COPD are almost twice as high as in patient groups with other chronic diseases.

A bouquet of symptoms

“Like other infections, the set of symptoms of RSV is wide. Babies may have difficulty breathing, fever, cough, wheezing, runny nose, and refuse to eat.

On the other hand, for a large part of adults, RSV can appear like any other cold. A slightly more specific symptom of RSV is wheezing and bronchospasm. In older people, RSV often manifests itself as pneumonia,” explains family doctor Linda Šauriņa.

How does this virus spread?

You can get sick by inhaling droplets from an infected person when they cough or sneeze. It can also be acquired from direct contact with droplets containing the virus, such as touching infected surfaces and then touching the nose or mouth. It should be noted that the virus can survive on hard surfaces for several hours. People infected with RSV can pass it on for about three to eight days. If the immune system is weakened, the illness can last up to eight weeks.

Testing is key to identifying viruses

Because the symptoms of RSV, influenza and Covid-19 are similar, it is a storm of all three circulating viruses. “The only way to make sure which of the viruses has affected is laboratory testing,” Jana Osīte is convinced. The most common are rapid antigen tests, antibody testing, and real-time polymerase chain reaction (PCR). Currently, respiratory virus and bacteria panels are relevant, which with special technology allow to quickly determine the presence of more than 20 respiratory viruses and bacteria in the examined sample at the same time,” says the doctor. It is worth considering ies

I can perform the test on babies up to 6 months of age, people over 65 years of age, as well as those with heart or lung problems or a weakened immune system,” Jana Osīte urges.

Treatment – relief of symptoms

“The care of a patient infected with RSV is usually the same as for other cold diseases – relief of symptoms with painkillers and anti-inflammatory drugs. Regardless of age, it is essential for patients to drink fluids to avoid dehydration,” reminds pharmacist Juta Namsone of “Mēnes Aptiekas”, adding that sometimes doctors also recommend specific medications for the treatment of asthma attack-like symptoms (inhaler or nebulizer).

“In the case of RSV, if breathing becomes too difficult, infants, especially those younger than six months, as well as older people may need hospitalization. Then the patient receives oxygen, liquid, especially in severe cases – is intubated and artificially breathed. There are no special medications for this infection, except in cases where people have a very weakened immune system, for example, when the patient has undergone an organ transplant,” explains family doctor Linda Šauriņa.

Recovery time varies

“It would be good for people to know exactly what they are sick with and how to recover. It is also important to realize that it is not possible to get well in one day,” emphasizes the pharmacist. For young children, it can be three to seven days. In adults, symptoms usually begin to improve within a week, and after two weeks you can expect them to be completely gone, but it may take longer to feel completely well. “It is not uncommon for people to complain about a prolonged cough at the pharmacy after allegedly being infected with a virus and ask for medicine to reduce it,” observed the pharmacist.

Contact your doctor!

“Any type of labored breathing will be a test for parents, especially if it’s an infant. You should definitely contact your doctor to know what to do in this situation. You should find out what medicines you should have at home, and get a prescription for those that cannot be purchased without a prescription. If you have a children’s inhaler at home, you can manage without hospitalization with the advice of a doctor. It should also be understood that the disease develops quickly, so it is important to be prepared for it and keep the necessary medicines and auxiliary devices at home. Unnecessary savings should not be made, but anti-inflammatory anti-fever medicines should be kept in the medicine cabinet at home. It is important to remember that acetylsalicylic acid preparations are not recommended for children under 16 years of age. To make it easier for the child to breathe, which may be difficult due to a runny nose, you can buy a nasal aspirator at the pharmacy,” says Juta Namsone.

RSV vaccines are still under development

Vaccines for influenza and Covid-19 are currently available, but there is no doubt that vaccines for RSV will also be available soon. Five different types of vaccines are being studied – live, attenuated, protein-based, nucleic acid and also recombinant vector vaccines. It is hoped that within the next year or two they could already be available. Most likely, vaccination will not be recommended for everyone, as it is, for example, in the case of influenza, but for children and the elderly, who are most at risk.

It is important to stop the spread of viruses

RSV spreads from person to person through coughing, sneezing, shaking hands. “The best prevention of RSV is to stop the spread of the virus. Cover your mouth when you cough and sneeze and wash your hands with soap and water for at least 20 seconds, carry hand sanitizer, and of course, wear a face mask in public. Masks can help provide triple protection – against Covid-19, against the flu, and also against RSV and other seasonal respiratory viruses,” emphasizes the family doctor.

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