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Respiratory Syncytial Virus May Kill as Many Elderly
as Flu
How to prevent it? Wash your hands.
Jan. 13, 2006 - Infectious disease experts at the
University of Rochester Medical Center have tracked the dangers from one
of the most common winter bugs, respiratory syncytial virus (RSV), and
they say the threat to some groups of people, such as the elderly,
equals that from flu. Even though flu gets all the press, RSV is a
stealth bug worthy of attention too.
While the world's attention has migrated to bird
flu, not a single person in the western hemisphere has contracted the
deadly form of the disease. And though "regular" flu is still a potent
threat, expected to kill more than 35,000 people in the United States
annually, your sick neighbor or colleague who probably doesn't have the
flu is a sniffling, sneezing, wheezing, whining reminder that there are
other germ threats.
Ann Falsey, M.D., and Edward Walsh, M.D., faculty
members in the University's Infectious Disease Unit of the Department of
Medicine, have found that RSV affects elderly and high-risk adults as
much as the flu.
In a paper published last year in the New England
Journal of Medicine, they estimated that 14,000 elderly and high-risk
adults die annually from an RSV infection, and that the bug is
responsible for more than 177,500 hospitalizations of adults each year.
In addition, pediatricians have long known that the
bug is a danger to small children, affecting hundreds of thousands of
children annually as the biggest cause of bronchiolitis and pneumonia
among infants and children under 1 year of age.
For more than a decade Falsey and Walsh, who are
infectious disease experts at Rochester General Hospital, have been on
the hunt for a vaccine against RSV.
While they've identified several proteins on the
surface of RSV, an important step toward creating a vaccine, none of the
vaccines they've tested has panned out.
So while people tense up about the availability of
flu vaccine or wait in long lines for a flu shot, that opportunity for
prevention doesn't even present itself for RSV.
Falsey and Walsh have shown that over a four-year
span in Rochester, about the same number of people visited the doctor
and were hospitalized for RSV and flu, and that RSV infection caused
more than 10 percent of hospitalizations for pneumonia during the
winter.
"At least with the flu, we have something to
control it – a vaccine," Falsey said. "We don't even have that for RSV.
The lack of awareness is a big problem. It costs a great deal of money
to develop a vaccine, but there's not much of a demand for a vaccine
against an illness that a lot of people haven't even heard of.
"A lot of cases that people think are from flu
aren't really the flu at all, but other respiratory viruses like RSV.
RSV is responsible for a lot of the illness blamed on flu," said Falsey,
whose work is funded by the National Institute of Allergy and Infectious
Diseases.
It's tough to tell RSV apart from the flu. Both are
primarily respiratory illnesses whose effects can range from simply
giving the person a few sniffles to causing life-threatening pneumonia.
Someone with the flu is more likely to have a fever and body aches, and
someone with RSV is more likely to have a runny nose, a cough that
produces mucus, and wheezing.
Flu is more likely to spread as an aerosol –
someone coughs and the airborne virus lands on another person, or they
cough and then touch the faucet or doorknob. RSV, like the common cold,
spreads mainly as large droplets via surfaces – doorknobs, faucets,
dishtowels, and hand-to-hand contact, for instance.
"Unlike the flu, RSV is more often spread directly
by secretions," said William Hall, M.D., a geriatrician and pulmonary
specialist at the University of Rochester Medical Center who has studied
how respiratory viruses are spread in communities like nursing homes.
"RSV lives on objects including faucets, door handles, and change from
the coffee shop, for quite awhile, for at least a day. If you put your
finger in your mouth, or touch your eye, or pick your nose, you're a
spreader, to put it bluntly. People share cell phones, they shake hands
to be social. These are effective ways to transmit disease."
While RSV may sound new, the best way to prevent it
– washing your hands – is not.
"We've known for more than 100 years that hand
washing prevents infection, but we still can't get people to wash their
hands," said Falsey. "Hand washing is the simplest, most effective way
to keep from getting sick and making others sick. But it's hard to get
people to wash their hands."
In the early 1990s Falsey led an experiment
involving hand washing among staff members at an adult day care center.
She found that respiratory infections were less frequent among residents
cared for by workers equipped with packs containing germ-killing hand
gels who used the gels regularly. The team also found that RSV was
spread to residents mainly through health care workers who had young
children at home.
While investigators like Falsey and Walsh search
for a vaccine against RSV, and a better way to check people who may have
the illness, for ordinary people the effects and treatment are largely
the same, whether a person gets the flu, RSV, the common cold, or
another respiratory ailment. Feel crummy. Rest, drink lots of fluids,
and if you suspect the flu, call a doctor immediately, because flu can
be treated effectively with new medications as long as it's caught
within the first 48 hours.
Simply put, there are a lot more infectious
invaders besides the flu to worry about. They don't get the big
headlines, but they still knock people down for days or weeks and cause
thousands of deaths each winter.
And, remember that there are a lot of other bugs
out there this time of year besides flu and RSV. Metapneumovirus.
Rhinoviruses. Coronaviruses. Parainfluenza – are more of the viruses
wafting through the air you breathe, looking to land in your eyes or
nose and set up house inside your body.
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