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Experts say RSV may increase risks for senior citizens

(From Left: Ms. SoYoung Seo, General Manager of GSK Philippines, Dr. Lourdes Dumlao, Geriatrics Expert, Dr. Lenora Fernandez, Pulmonology Expert, Dr. Rontgene Solante, Infectious Disease Expert, Ms. Nanette Inventor, Artist and Educator, Dr. Gio Barangan Country Medical Director of GSK Philippines and Mr. Richard Arboleda, Communications, Government Affairs and Market Access Lead of GSK Philippines)

Public health experts are raising concerns for senior citizens and Filipinos with comorbidities regarding the serious risks associated with Respiratory Syncytial Virus (RSV). According to the Philippine Statistics Authority, the country has over 9 million seniors aged 60 and above.[1] Seniors, especially those who have comorbidities, are at higher risk of severe Respiratory Syncytial Virus (RSV) infections due to their weakened immune systems.[2]

Dr. Rontgene Solante, an Infectious Disease Expert and President of the Philippine College of Physicians, describes RSV as a widespread yet lesser-known respiratory virus that transmits through inhalation or contact with respiratory secretions of those infected.[3] It typically manifests symptoms including congestion, cough, wheezing, and low-grade fever.[4]

“Identifying RSV from other respiratory diseases is difficult because of its non-specific symptoms similar to other illnesses. Diagnosis requires testing that is often expensive and not widely accessible. Seniors and individuals with comorbidities may mistake their symptoms for a common cold or flu, not realizing they could be suffering from RSV, which can result in severe long-term damage or even fatal complications. More concerning is that there is no specific treatment for RSV in adults,”[5] says Dr. Solante.

He emphasizes that while RSV can infect individuals at any time of the year, it spreads more intensively during the rainy months from September to February, peaking in the colder months of October and December.[6][7] This highly contagious virus spreads easily within households,7 where one infected person typically infects three others,[8] and while most are infectious for 3-8 days,[9] older adults may transmit the virus for extended periods.[10]

“Our seniors are particularly susceptible and vulnerable because, in Philippine culture, they often live with family members who also serve as their caregivers. These family members may unknowingly contract RSV at work or elsewhere and bring it home to their senior relatives. Within the household, symptoms might be dismissed as just the flu, not realizing that what’s circulating is RSV, which can be fatal for seniors.” says Dr. Solante.

 

RSV imposes a greater burden and necessitates extensive aftercare for seniors 

Dr. Lourdes Dumlao, President of the Philippine College of Geriatric Medicine, observes that RSV is often depicted as a pediatric illness[11] on social media because children, like seniors, have weak immune systems, making them vulnerable. However, she emphasizes that RSV presents a greater burden on seniors.[12]

Dr. Dumlao explains, “Studies have shown that the incidence of hospitalizations and mortality due to RSV is substantially higher in seniors than in children.[13]  Seniors with certain underlying conditions such as pneumonia, congestive heart failure (CHF), asthma, and chronic obstructive pulmonary disease are at higher risk of hospitalization when infected with RSV.[14] Additionally, RSV can cause various severe respiratory complications in older adults, including arrest and failure, respiratory distress, and emphysema.[15] Further, about 30% of older adults may develop heart complications when hospitalized with RSV.”[16]

Dr. Lenora C. Fernandez, head of Pulmonary Services at Asian Hospital and Medical Center and former President of the Philippine College of Chest Physicians, highlights the extensive aftercare needed by RSV patients even after hospital discharge, stressing the burden this imposes not only on the patients themselves but also on their families.

Dr. Fernandez says, “One out of four RSV patients (24.5%) may require professional home care after hospital discharge.17 Additionally, up to one out of four (26.6%) of these patients are readmitted within three months post-discharge,[17] and even more concerning, three out of ten (33%) may die from complications related to RSV within a year of their initial admission.”[18]

 

Awareness and Proactive Health Measures to Protect Seniors from RSV

Dr. Solante emphasizes the importance of education in mitigating the health risks of RSV and highlights the need for both seniors and their caregivers to be well-informed.

“RSV is difficult to detect and prone to misinformation so I advise seniors to discuss RSV with their doctors who can guide them on the necessary precautions to reduce their health risk,” he advises.

Dr. Fernandez suggests immediate action if flu-like symptoms appear within the household. “I recommend that families implement safety and hygiene protocols promptly to protect their seniors, such as isolating symptomatic individuals, wearing face masks, and engaging in frequent handwashing,”[19] she adds.

Dr. Dumlao reinforces the timeless advice that prevention is better than cure. “Seniors must be proactive about their health,” she states. “Through regular medical consultations, seniors can ensure they receive the right interventions to mitigate RSV risks, while also adopting healthy habits like maintaining a healthy diet, getting adequate sleep, and engaging in regular exercise to boost their immune system.”

[1] Philippine Statistics Authority. Age and Sex Distribution in the Philippine Population (2020 Census of Population and Housing). Retrieved from: https://www.psa.gov.ph/content/age-and-sex-distribution-philippine-population-2020-census-population-and-housing [2] United States Center for Disease Control and Prevention. RSV in Older Adults and Adults with Chronic Medical Conditions. Retrieved from: https://www.cdc.gov/rsv/high-risk/older-adults.html [3] Centers for Disease Control and Prevention (CDC), 2023. RSV transmission. www.cdc.gov/rsv/about/transmission.html [4] Falsey, A. & Walsh, E. (n.d). National Library of Medicine. Respiratory Syncytial Virus infection in elderly adults. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/16038573/ [5] Nam HH and Ison MG. BMJ 2019;366:l5021 [6] World Health Organization. Global Influenza Surveillance and Response System (GISRS). https://www.who.int/tools/flunet [7] Otomaru H et al. Am J Epidemiol 2021;190:2536–2543 [8] Walsh EE et al. J Infect Dis 2013;207:1424–1432 [9] Centers for Disease Control and Prevention (CDC), 2023. RSV transmission. Retrieved from: www.cdc.gov/rsv/about/transmission.html [10] Walsh EE et al. J Infect Dis 2013;207:1424–1432 [11] Emily Halnon (2023). Health Central. Myths and Facts About Respiratory Syncytial Virus. Retrieved from: https://www.healthcentral.com/slideshow/myths-and-facts-about-respiratory-syncytial-virus [12] Clevaland Clinic. RSV (Respiratory Syncytial Virus). Is RSV deadly? Retrieved from: https://my.clevelandclinic.org/health/diseases/rsv-respiratory-syncytial-virus [13] National Foundation for Infectious Diseases (NFID), 2023. Respiratory Syncytial Virus (RSV) Retrieved from: https://www.nfid.org/infectious-disease/rsv/ [14] National Library of Medicine. (La et al., 2024). Respiratory syncytial virus knowledge, attitudes, and perceptions among adults in the United States. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10841020/ [15] Maggi et al. Vaccines 2022, 10(12), 2092. Retrieved from: https://doi.org/10.3390/vaccines10122092 [16] Falsey et al. 2018. Respiratory syncytial virus–associated illness in adults with advanced chronic obstructive pulmonary disease and/or congestive heart failure. Retrieved from: https://doi.org/10.1002/jmv.25285 [17] Falsey AR et al. Open Forum Infect Dis 2021;8:11, ofab491 [18] Tseng HF et al. J Infect Dis 2020;222:1298–131 [19] Forbes M. Am J Health Syst Pharm. 2008 Dec 1;65(23 Suppl 8):S13-9. doi: 10.2146/ajhp080440

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