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Centers for Disease Control and Prevention

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Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious. Infants and older adults are more likely to develop severe RSV and need hospitalization. If you are age 60 or older, a vaccine is available to protect you from severe RSV. Talk to your healthcare provider to see if it's right for you. If you are pregnant, you can get an RSV vaccine between 32-36 weeks of pregnancy to protect your infant after birth, or a preventive antibody can be given to your baby after birth.

Know the symptoms to look for and how to care for people with RSV.

Preventive options help protect certain groups at high risk of severe RSV.

Help protect yourself and your loved ones from RSV infection.

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Learn about Respiratory Syncytial Virus Infection (RSV).

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Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms but can be serious.

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RSV video by Cleveland Clinic

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RSV stands for Respiratory Syncytial Virus. This is a virus that most people get during their lifetime, but it is especially dangerous for young babies, children and the elderly. RSV is a virus that can cause lung and airway infections such as bronchiolitis and pneumonia

RSV is spread through contact with infected droplets. It can also be spread through touching spaces that has the virus on it. People who get RSV are usually contagious for 3-8 days; sometimes they can become a contagious a day before they begin showing symptoms.

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Credit: Science Photo Library/ 2017 Ella Maru Studio 

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The causative agent is a virus, called Respiratory Syncytial Virus. It is part of the of the Paramyxoviridae class- it is special because it is distinct from other viruses in the same class. It is under the genus orthopneumovirus. RSV is a negative stranded RNA virus that is enveloped and non-segmented.

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RSV is a virus that can cause many other infections, especially to infants, young children, elderly and to those who are immunocompromised.

1. Bronchiolitis

Bronchiolitis is a respiratory tract infection. It happens when the bronchioles(airways that carry oxygen) in the lungs get infected with a virus (such as RSV) and swell up. This makes it harder to breathe, as there is less space for the air to pass through. The bronchioles can also get backed up with mucus, which also makes it hard to breathe.

2. Lack of interest in playing in babies and young children/fatigue

In adults and children, RSV can cause fatigue. This is because your body is trying to fight off the virus and is using a lot of energy to do that while still carrying out other bodily functions. As a result, people infected with RSV can feel tired. In babies and young children that do not yet speak may exhibit fatigue and may not have an interest in playing.

3. Fever

RSV can cause fevers. fevers are a way that the human body tries to protect itself, in raising body temperature so that the virus may die off because of the excessive heat. High fevers can happen when the RSV infection is more severe.

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In most cases regarding otherwise healthy adults, diagnosis may not be done, as adults may be more likely to stay home and recover. However, in severe cases, RSV may require a trip to the doctor's.

Diagnosis

RSV may be diagnosed by getting blood. The blood is then tested for white blood cell counts or to look for the virus. A doctor will also listen to the patient's lungs to hear whether the patient is breathing abnormally or normally. In severe cases, the patient may receive a chest x-ray to determine where the lungs are inflamed.

Treatment

In most cases, doctors will recommend over the counter medications such as Tylenol and Ibuprofen to bring down fever and manage symptoms. They will also recommend for the patient to get lots of rest and to stay fed and hydrated. In severe cases of RSV, patients may need to be hospitalized. In these cases, patients may receive intravenous fluids as well as oxygen. In cases where the patient cannot breathe on their own, patient will be hooked up to breathing support machines.

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RSV can be prevented by washing hands and staying away from those who are infected by the virus. It is also important to stay home when sick, clean areas that are used frequently, as well as avoiding sharing communal household items.

RSV can also be prevented by vaccination. There is a CDC recommendation that adults older than 60 receive a single dose RSV vaccination.

Maternal vaccination can also take place. Those who are pregnant and between 32-36 weeks of pregnancy can receive an RSV vaccination, and the baby will be vaccinated as well. If the mother does not want to receive the vaccination, there is also an RSV vaccine available for babies.

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Credit: National Foundation for Infectious Diseases 

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This was a study done in 2020 that studied the safety of giving an RSV vaccine to pregnant mothers. This was a study that was done with a placebo in many different countries around the world. Pregnant moms were given a RSV vaccine and then their child was monitored after birth. In the figure that displays this above, they found that the RSV vaccine performed significantly differently than the placebo. It was determined that this vaccine was safe for use, and they found that maternal vaccination was associated with lower rates of lower respiratory tract infections. This was a groundbreaking study because it was of a large scale, about 4,600 participants took part in this study, and it added to the research that the RSV vaccine was safe to use. The RSV vaccine is now medically available.

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Dr. Matthew Snape-Professor in General Pediatrics and Vaccinology at the University of Oxford https://www.immunology.ox.ac.uk/about/team/matthew-snape

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In the News: RSV, COVID-19, flu rise in Bay Area

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In the News: RSV, COVID-19, flu rise in Bay Area

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They warned us - and their predictions are playing out.

After a summer wave of COVID cases receded heading into the fall, public health officials cautioned that SARS-CoV-2 was likely to stage a winter return accompanied by other respiratory viruses such as influenza and RSV. While it's too soon to measure the impact of Thanksgiving travel and family gatherings, the metrics are already showing a sharp uptick.

The Bay Area is seeing a resurgence of COVID-19 at the same time as a pronounced influenza wave and a troubling climb in the prevalence of respiratory syncytial virus. The gathering "tripledemic" prompted a coalition of regional health officers to issue joint recommendations on Thursday for safely navigating the upcoming holiday season - and it included strongly worded advice for some people to wear protective masks.

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Data published Friday by the California Department of Public Health show a 48% surge in COVID-19 hospitalizations over the past month, totaling 2,088 admissions in the week ending Nov. 25. California's COVID-19 test positivity rate climbed from 6.1% to 8.3% during the same period, and the coronavirus' share of all fatalities rose from 1.5% to 2.7%.

Nationwide, COVID-related hospitalizations continued to increase for the third consecutive week, with over 19,400 new admissions reported in the week ending Nov. 25, according to figures released Friday by the U.S. Centers for Disease Control and Prevention.

CDC Director Dr. Mandy Cohen reminded a House committee hearing Thursday that federal health officials had anticipated an uptick following the Thanksgiving period.

"At this time, what we are seeing is quite typical of this moment in the winter respiratory virus season," Cohen said.

Wastewater data from the CDC indicates that COVID levels across the country are currently high and trending upward, poised to exceed peaks notched earlier this year. There is also a surge in hospitalization rates for both flu and RSV, accompanied by unusually high outpatient visits for respiratory illnesses.

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The rise in California influenza cases is especially noteworthy, with a 400% increase in hospital admissions, to an average of 71 per day compared to just 14 last month. At the same time, the state's three-week moving average positivity test rate for RSV has soared to 21%, more than doubling in a month.

"RSV season is in full swing," Cohen said. "Flu season is just beginning across most of the country, though accelerating fast."

However, she added, "Even though those are both going up and we're at the peak of RSV, COVID is still the respiratory virus that is putting the most number of folks in the hospital and taking their lives."

In response to these escalating concerns, health officers from all nine Bay Area counties and neighboring regions put out their unified call to action on Nov. 30, reminding residents to protect themselves during the holidays.

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These measures include targeted vaccination against COVID-19, flu and RSV, staying home when sick, prompt testing for symptoms and seeking timely treatment. Of note, they made specific recommendations for masking in indoor public spaces, advising people over 65 or those who are immunocompromised to consider wearing a well-fitting high-quality face coverage, such as a KF94, KN95 or N95 respirator.

"Wearing a mask can reduce your risk of getting sick and missing out on work, school, and holiday events," the bulletin said.

They also reminded Bay Area residents who socialize with vulnerable people to consider masking as well. "This helps protect people around you, especially those at higher risk of serious illness."

About a third of adults and children in the U.S. have received their flu shot this year, according to the latest CDC data. Approximately 16% of adults and 6% of children have gotten the new COVID-19 vaccine - figures below the agency's desired benchmarks.

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"That's not enough," Cohen said.

Moreover, only 15% of older adults aged 60 and above have received the new RSV vaccine.

Health officials are now monitoring for other viral and bacterial outbreaks. This week, authorities in Ohio and Massachusetts reported a spike in pediatric pneumonia cases tied to pathogens including adenovirus, Streptococcus pneumoniae and Mycoplasma pneumoniae - bacteria that may be associated with a surge in respiratory infections in China.

Children are suffering disproportionately from the increase in respiratory illnesses, with approximately 75% of pediatric hospital beds currently in use across the nation, according to federal data, marking the highest demand since last December.

Reach Aidin Vaziri: avaziri@sfchronicle.com

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u.s. centers for disease control and prevention

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Rise in COVID, flu and RSV prompts Bay Area health recommendations - including masking

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The gathering "tripledemic" prompted Bay Area health officers to issue joint recommendations for safely navigating the upcoming holiday season.