When entering the rainy season, a common health problem caused by changing weather conditions is respiratory tract infections caused by the RSV virus, especially in young children and the elderly. This causes excessive phlegm, leading to lung inflammation and swelling of the bronchial mucosa and various respiratory tracts. This results in children experiencing shortness of breath and difficulty breathing, while elderly people, who often have weakened bodies or underlying diseases, are at high risk of severe complications from RSV infection, such as pneumonia, bronchitis, and respiratory failure, which can be life-threatening.
Getting to know the RSV virus, its transmission methods, and prevention guidelines can help us effectively prevent and manage infections.
What is RSV?
RSV or Respiratory Syncytial Virus is a virus that causes infections in both the upper and lower respiratory tracts. Infections are mostly found in young children and the elderly, especially
- Young children under 3 years old
- Elderly people aged 65 and above or those with weakened bodies, who are at high risk of severe complications from RSV infection
RSV outbreaks in Thailand usually occur during the rainy and winter seasons. It spreads easily in crowded places such as schools and elderly care facilities. RSV can survive in the environment for several hours and on hands for more than half an hour if not washed properly. The incubation period is about 4-6 days after exposure.
What are the symptoms of RSV? When should you see a doctor immediately?
Symptoms indicating RSV infection, especially in the elderly, include:
Initial symptoms (usually occur within 4-6 days after exposure)
- Mild fever: Body temperature may rise slightly, but some elderly may not have a fever
- Runny nose: Usually clear nasal discharge at first
- Sore throat: May feel irritated or burning in the throat
- Dry cough: Mild coughing begins
If left untreated, the following symptoms may occur:
- Increased coughing: More frequent cough with possible phlegm
- Wheezing: Whistling sound when exhaling
- Rapid and shallow breathing: Increased breathing rate
- Shortness of breath: Feeling easily tired even with light activities
- Loss of appetite: Eating less
- Fatigue: Feeling unusually tired
- Worsening of underlying diseases: Such as asthma exacerbation or difficulty controlling diabetes
Symptoms requiring immediate medical attention
- Severe difficulty breathing, rapid breathing, or use of accessory muscles to breathe
- High fever that does not subside, especially above 39 degrees Celsius
- Rapid and obvious worsening of symptoms
- Inability to eat or drink, risking severe dehydration
- Seizures or loss of consciousness, which are dangerous signs requiring urgent help
How to tell if an elderly person has RSV infection and how symptoms differ from other diseases?
Since RSV infection symptoms are similar to the common cold, the difference is that RSV may cause fever and lasts longer than a common cold, usually 5-7 days, with more pronounced respiratory symptoms. RSV infection does not cause loss of smell or taste, unlike COVID-19.
To reduce the risk of severe complications, if an elderly person shows suspicious symptoms as mentioned, close monitoring and observation are important, and they should be taken to see a doctor immediately if concerning symptoms appear.
Causes of RSV infection in the elderly
RSV infection in the elderly can result from various causes related to both internal and external factors as follows:
- Weakened immunity in the elderly
The elderly often have naturally weakened immune systems (Immunosenescence). The production of B cells and T cells decreases, leading to less effective responses to pathogens. Additionally, the immune system’s ability to remember pathogens is reduced, making reinfection easier.
- Environment and living conditions
Living in places where contact with infected individuals is possible, especially living with young children who may be RSV carriers, or being in crowded areas with poor ventilation, or traveling to areas with RSV outbreaks are important causes that make the elderly more susceptible to infection.
- Underlying diseases
Most elderly people have underlying diseases, making them more susceptible to infection, especially those with chronic lung diseases such as COPD or asthma, which weaken the lungs and increase infection risk. Heart disease affects blood circulation and oxygen delivery to the lungs. Diabetes impairs immune system function, and chronic kidney disease affects waste removal and immune function. Elderly people in these groups often experience severe symptoms when infected with RSV.
- Hygiene behaviors
Hygiene is also a common cause. Neglecting it increases risk for the elderly, such as irregular or improper handwashing, frequently touching the face, eyes, nose, or mouth without washing hands, or not wearing masks in public or when sick.
- Malnutrition
Elderly people lacking essential nutrients such as vitamin C, vitamin D, and protein, as well as those who are dehydrated, have impaired immune system efficiency, making them more susceptible to RSV. Chronic stress, insufficient or poor-quality sleep also weaken the body and negatively affect the immune system, increasing susceptibility to infection.
How is RSV transmitted?
People infected with RSV can spread the virus for 3-8 days and transmit it directly through contact with secretions such as nasal mucus, saliva, and phlegm.
How dangerous is RSV in the elderly?
RSV infection in the elderly is often more severe than in other age groups due to weakened immune systems and common underlying diseases, increasing the risk of severe complications.
Severity levels
- Mild symptoms: Some elderly may only have symptoms similar to a common cold
- Moderate symptoms: May have high fever, frequent coughing, difficulty breathing but do not require hospitalization
- Severe symptoms: May lead to pneumonia, respiratory failure, or require treatment in the intensive care unit (ICU)
Prevention and treatment of RSV
Currently, research and development of vaccines to prevent RSV infection in the elderly are ongoing, but there is no direct antiviral treatment for RSV. Treatment is symptomatic and supportive, such as giving fever reducers, suctioning phlegm, and bronchodilators for those with bronchial constriction.
In severe cases, oxygen therapy may be provided. The duration of treatment depends on the individual’s physical condition and disease severity.
Guidelines for preventing RSV infection in the elderly
- Wash hands frequently with soap and water for at least 20 seconds
- Use alcohol-based hand gel when soap and water are not available
- Avoid touching eyes, nose, and mouth with unclean hands
- Use tissue to cover mouth and nose when coughing or sneezing and dispose of it immediately after use
- Wear a mask in public, especially during outbreaks
- Avoid gatherings, especially during outbreaks
- Avoid close contact with young children or grandchildren who have cold symptoms or runny nose
- Maintain health by eating a balanced diet with all five food groups, exercising regularly according to physical condition, and getting enough rest
- Keep the environment clean, disinfect frequently touched surfaces, open windows for ventilation at home or work, and manage underlying diseases well, such as diabetes and hypertension, by taking medications regularly as prescribed by a doctor
Is there an RSV vaccine for the elderly?
Currently, RSV vaccines for the elderly are being continuously developed to help prevent and reduce the risk of infection and severity of RSV and other complications directly.
According to preliminary research, the RSV virus vaccine (Respiratory syncytial virus; RSV) is used to stimulate immunity to prevent lower respiratory tract disease (LRTD) caused by respiratory syncytial virus. The vaccine helps reduce the risk of severe illness from infection with just one dose.
RSV in the elderly can be prevented
Preventing RSV infection in the elderly is important and requires cooperation from the elderly themselves, their families, and the surrounding community. Strict and consistent preventive measures combined with holistic health care will effectively reduce the risk of RSV and other respiratory infections, allowing the elderly to live safely and with a good quality of life.
