More than just a cold: Understanding the respiratory syncytial virus
Health experts highlight how this highly contagious disease affects vulnerable populations and share insights on prevention and risk reduction.
by Brand Studio · CNA · JoinThe highly contagious respiratory syncytial virus (RSV) typically causes mild illness, but it can lead to severe respiratory complications, particularly for at-risk individuals.
Drawing on local research, Dr Leong Hoe Nam, an infectious disease physician at Rophi Clinic, shares that RSV infections tend to peak around the middle of the year, between May and September. The infection often begins with cold-like symptoms, including nasal congestion, runny nose, sore throat and fever.
However, there is a key difference that sets RSV apart from other respiratory infections. Dr Mas Suhaila, consultant paediatrician at Kinder Clinic, explained: “Respiratory infections such as the flu cause mild-to-severe symptoms that tend to come on suddenly, whereas RSV symptoms tend to present more gradually.”
THE IMPACT OF RSV ON VULNERABLE POPULATIONS
RSV poses a significant threat to several high-risk groups. For example, in infants, early signs of severe RSV can appear around the third to fifth day of illness. “Watch out for fast, short and shallow breathing, irritability, unusual tiredness, poor appetite and high fever. Infants, especially those under six months, may experience episodes of abnormal pauses in breathing, too,” shared Dr Mas.
Additionally, babies born prematurely, children under the age of two and those with underlying conditions such as chronic lung or heart disease, or a weakened immune system, are at an elevated risk for RSV complications. “Their immature immune system coupled with lung inflammation adds burden to the heart and lungs. Furthermore, the smaller airways of infants and children make them more susceptible to complications when airways are inflamed,” she explained.
RSV is a common cause of bronchiolitis (inflammation of the small airways in the lungs) and pneumonia in infants. “The resulting breathlessness, poor oxygenation and failure to breathe can be life-threatening,” Dr Mas noted.
Another at-risk group consists of older adults, particularly those aged 60 and above. Indicators of severe RSV-related complications in this group include a wet cough, wheezing and gasping for breath.
Dr Leong highlighted that the infection can lead to lower respiratory infections such as pneumonia and bronchitis. “These infections are particularly challenging for individuals over 65 due to their weakened immune systems. Moreover, those with pre-existing medical conditions, especially heart or lung-related issues, are more vulnerable to complications from RSV,” he said.
RSV also poses significant risks to residents of long-term care facilities and those with compromised immune systems, including transplant recipients and individuals on steroid therapy or other immunosuppressants. In the most severe cases, RSV may even be fatal, Dr Leong added.
REDUCING RSV RISKS
RSV spreads mainly through droplets from an infected person’s coughs and sneezes, which can come into contact with another person’s eyes, nose or mouth. It can also be transmitted through contact with contaminated surfaces.
To prevent the spread of RSV, Dr Leong emphasised the importance of practising good hand hygiene, wearing masks and maintaining a safe distance (of 2m or more) from unwell people. He also advised against sharing items like cups, as the virus can survive on surfaces for several hours.
Dr Leong pointed out that there is currently no effective treatment for RSV in Singapore; prevention through vaccination is key to minimising complications from the illness.
ADOPTING A PREVENTIVE APPROACH
According to Dr Leong, vaccination works by stimulating the immune system to produce antibodies. The RSV vaccine contains a protein from the respiratory syncytial virus. When administered, it triggers the immune system to respond, creating protection that helps stave off severe infection.
“In randomised controlled trials, a single dose of RSV vaccine has shown moderate-to-high effectiveness in preventing RSV-associated pneumonia during RSV season. Notably, this effectiveness was sustained the next year, indicating that yearly vaccination might not be required,” said Dr Leong.
He added that since May this year, an RSV vaccine has been available in Singapore for older adults over the age of 60.
The Health Sciences Authority has recently approved another RSV vaccine that provides protection not only for older adults, but also infants through maternal immunisation. Dr Mas shared: “Pregnant women can receive a single dose of the RSV vaccine approved for maternal immunisation between weeks 32 and 36 of pregnancy.”
Dr Mas explained that maternal immunisation protects both the mother and her baby. It stimulates the production of antibodies that can cross the placenta, conferring protection to the infant from birth, when they are at the highest risk of severe RSV.
“In a study conducted in 18 countries, maternal immunisation was shown to be effective in preventing severe RSV-associated lung disease in infants. The vaccine demonstrated an efficacy of 81.8 per cent within 90 days after birth, and 69.4 per cent within 180 days after birth, with no safety concerns identified,” she elaborated.
Both doctors noted the importance of adopting a prevention mindset, aligning with the goal of protecting loved ones from severe RSV complications.
“RSV is a life-threatening infection that can cause significant despair for families,” said Dr Leong. “Doctors may be limited in their treatment options, making prevention through vaccination one of the most effective methods to safeguard health.”
Speak to your doctor to learn more about RSV.
This article is sponsored by Pfizer Singapore. The opinions expressed in this article are solely those of the expert(s), speaker(s) or participant(s) featured herein. This material is intended for educational and/or disease awareness purposes only and should not be used as a substitute for consulting a healthcare professional. For more information, speak to a healthcare professional. References are available upon request.
PP-RES-SGP-0032/09SEP2024
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