The burden of RSV in the older population is becoming highly recognized as studies have assessed higher-risk individuals in industrialized and developing countries.
New study findings highlighted the need for additional research to assess the burden of respiratory syncytial virus (RSV) among older adults. Published in Current Opinion in Infectious Diseases, the study authors noted that prior to the release of 2 RSV vaccines, evaluating the effectiveness, rare adverse effects, and inclusivity could benefit their potential. Additionally, the study highlights the impact RSV can have on adults 60 years and older.
RSV infection can create upper respiratory and/or lower respiratory tract symptoms that present as sore throat, runny nose, nasal congestion, recurrent cough, shortness of breath, and sputum among older adults. Other symptoms could include nausea, vomiting, diarrhea, fever, fatigue, weakness, disturbed sleep, and malaise.
In most cases, individuals experience mild symptoms that self-resolve. However, a small percentage of cases among individuals that experience lower respiratory tract infections result in hospitalization or death, according to study authors. Those vulnerable to more serious reactions include individuals that reside in long-term care facilities, individuals that present with frailty, those older than 75 years, those who are immunocompromised or in need of an organ transplant, and those with chronic conditions.
Researchers evaluated the incidence rates of RSV and found inconsistencies in yearly data due to a lack of testing and diagnostic tools among adults.
However, the study authors noted that assessing the RSV burden in older adults is difficult because of unawareness and untimely testing among older adults, which can lead to inaccurate estimates of illness. When older adults are tested late, viral presence is often diminished. To mitigate this issue, researchers in a recent study found that RSV prevalence increased from 1.8% to 4.5% when saliva and sputum was added when swabbing.
A recent study using data from a meta-analysis assessed RSV-related hospitalizations among adults 65 years and older, and found that cases could be as high as 787,000 in industrialized countries. Additionally, the annual mortality rate among those infected could be as high as 47,000.
In a community-based study that also assessed the burden of RSV in older adults from industrialized countries, investigators focused on the prevalence and incidence rate of RSV and acute respiratory infections. Compared to the previous hospital-based study, the study authors noted that they were able to provide more accurate data on the impact of RSV in a health care setting. However, there are limited community-based studies that have researched the disease burden of RSV in older adults, outside of data from industrialized countries.
Further studies have compared the burden of seasonal influenza with RSV to help identify the morbidity and mortality in older adults. Unlike RSV, influenza is well recognized as an issue among the older population. Researchers Falsey et al. analyzed data throughout 4 winters in Rochester, New York, and found that the burden of RSV was slightly lower or comparable to influenza. The study authors noted that the use of health care services among adults that were high risk was similar. Additionally, those included in the hospital cohort of the study both had similar lengths of stay, intensive care, and mortality.
Following the release of the RSV vaccines for older adults in the United States, the study authors noted that both immunizations displayed positive effects.
“The Advisory Committee on Immunization Practices estimates that in the US alone, every one million vaccine doses given over two seasons would prevent 41 000–44 000 outpatient visits, 3190 to 3460 hospitalizations and 155 to 167 deaths in adults ≥ 60 years of age,” said authors in a press release.
The findings suggest that the burden of RSV in the older population is becoming highly recognized as more studies have assessed higher risk individuals in industrialized and developing countries. However, the study authors noted that more research is needed to monitor adverse effects to successfully manage RSV is older adults.
The disease burden of respiratory syncytial virus in older adults. Wolters Kluwer. News release. January 11, 2024. Accessed January 29, 2024. https://journals.lww.com/co-infectiousdiseases/fulltext/9900/the_disease_burden_of_respiratory_syncytial_virus.132.aspx.