Revised mask-wearing requirements at our Medical Centre and Hospital

What is Respiratory Syncytial Virus?

  • 10 Oct 2023
  • 3 mins

A respiratory tract infection, commonly referred to as a “cold”, is an infection of the lungs, airways, sinuses, or throat. It occurs year-round, with infections increasing during the flu season. Although you could have symptoms associated with the common cold, you could instead be suffering from respiratory syncytial virus (RSV).

Despite affecting 64 million people and causing 160,000 deaths yearly, familiarity with RSV is less common as compared to the common flu. RSV is a highly contagious virus that usually causes upper respiratory tract infections in most people. In infants, very young children (below the age of two), and the elderly, it can cause pneumonia, bronchiolitis, and the exacerbation of chronic respiratory diseases such as asthma.

Symptoms of RSV

Some common symptoms of RSV include a runny nose, nasal congestion, coughing, and postnasal drip. Although it shares some symptoms with the common cold, RSV in fact belongs to a family of viruses called Pneumoviridae while the common cold is caused by the rhinovirus and human coronavirus (not to be confused with Covid). Symptoms of RSV also tend to come on more gradually as compared to the common cold. 

Although adults with RSV are usually not too severely affected by the virus, infants and young children tend to be more seriously affected as they have very small airways and are hence more susceptible to the effects of the virus as it causes the airways to be inflamed, making it difficult to breathe. Some of the more severe complications of RSV, according to infectious diseases expert Dr. Loh Jiashen, involve hospitalization from pneumonia and the sudden cessation of breathing in children.

“In immunocompromised cohorts, the risks of severe disease and pneumonia increases,” Dr. Loh adds. “In haematopoietic cell transplant recipients, mortality exceeding 50% has been reported.”

While in adults, severe respiratory infections may be complicated by cardiovascular events. Though, there are usually few long-term effects after one makes a full recovery, RSV does increase an infant’s long-term risks of developing asthma and other breathing disorders later in life.

Treatment & Management of RSV

Thankfully, the most effective means of protection against RSV are also some of the simplest.

Avoid close contact with infected people, and if you believe yourself to be infected, it is advised you avoid close contact with young children and the elderly. Avoid sharing cups and toys that have been contaminated, as the virus can live on surfaces for hours, and thoroughly wash your hands after coming into contact with an infected person. Vaccination against RSV is another way to reduce the risk of contracting the virus.

For the first time ever, in August 2023, the US Food and Drug Administration (FDA) approved the use of Abrysvo, an RSV vaccine, for use in pregnant individuals to prevent lower respiratory tract disease (LRTD) and severe LRTD caused by RSV in infants from birth until they are six months old. The vaccination will be able to immunize the infants against RSV, as maternal antibodies produced by the pregnant mothers can cross the placenta and protect the infant against RSV.

Aside from vaccination, Dr. Loh shares another method to confer resistance to RSV among infants and young children.

“A monoclonal antibody is recommended for children at high risk of RSV infection. However, this is not a traditional vaccine,” says Dr. Loh. “It is a concentrate of antibodies targeted against RSV and does not induce the body to create its own antibodies.”

There are also currently two licensed RSV vaccines (Abrysvo and Arexvy) available for older adults over 60 years old.

Global hospitalizations of children due to RSV is estimated to be around 3.6 million and in-hospital deaths is estimated to be around 26,000 yearly. Meanwhile, global hospitalisations for older adults are estimated to be around 336,000, with in-hospital deaths estimated to be at 14,000. There is currently no cure for RSV, with healthcare providers typically treating the symptoms and doing their best to support the patient. Thus, preventive tactics like vaccinations for the elderly and pregnant mothers for infants can have a significant impact in reducing the hospitalization and mortality statistics for RSV cases.

According to Dr. Loh, as the RSV vaccine for pregnant mothers has only just been approved in August 2023, it remains to be seen when the vaccine will be available in Singapore. It might take up to a year before pregnant mothers in Singapore are able to get the vaccination.

Contributed by

Dr. Loh Jia Shen
Infectious Disease Specialist
Farrer Park Hospital