As the Adult Respiratory Virus that Goes Unnoticed, RSV

Andrew Busack*
 
*Correspondence: Andrew Busack, Department of Medicine, Medstar Washington Hospital Center, Washington, DC 20010, USA, Email: Andrewbusack@gmail.com

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Introduction

One of the most significant viral infections causing respiratory illnesses is RSV. From cold-like symptoms to life-threatening lower respiratory tract infections, clinical symptoms can range greatly. Additionally, exacerbations of underlying cardiopulmonary illness have been linked to RSV as a cause. Long-term care facility residents, people with underlying lung and/or heart conditions, the elderly, and people with immunocompromised patients (especially those who are actively receiving chemotherapy for hematologic malignancies) are all at a higher risk of developing severe RSV diseas. Many people still underestimate the severity of RSV disease due to insensitive RSV detection techniques and a general lack of RSV screening [1]. In fact, mounting data indicate that RSV is both more common and expensive than previously believed. For instance, a recent metanalysis when a nasopharyngeal RT-PCR test was combined with a sputum RT-PCR test or by using paired serology specimens, RSV detection was found to be 1.4–2 times higher. RSV is anticipated to be the cause of around 159,000 hospitalizations, 119,000 ED admissions, and 1.4 million outpatient visits each year among US people aged 65 and older, according to data from previous assessments applied to the population of the US Census in 2022 [2].

Description

Clinically, RSV's respiratory infection is similar to that caused by other respiratory viruses. Around 3-5 days after the first infection, patients most frequently have upper respiratory infection (URI) symptoms such nasal congestion and rhinorrhea (22–78%). Fever is typical in kids, and 40% of babies get bronchiolitis, a lower respiratory infection that causes coughing and wheezing. The prevalence of RSV-related illness in newborns and young children has been extensively defined, thus this review won't go into additional detail. Repeat infections are typically limited to the upper respiratory tract in young, healthy individuals, with nasal congestion, tiredness, fever, and cough being the main symptoms. However, the virus proceeds in a small percentage of patients to infect the lower respiratory tract, resulting in Dyspnea, wheezing, and a cough [3]. According to a retrospective cohort study done in Hong Kong, 70% of individuals referred to the hospital with RSV also had problems from lower respiratory tract infections, such as pneumonia, bronchitis, or flare-ups of asthma or COPD. 49.3% of patients had radiographic findings that are consistent with acute pneumonia, most frequently consolidations (23.8%) and ground-glass opacities (19.9%) that are difficult to identify from other infectious pneumonia causes. Additionally, bacterial co-infections are frequent; at the time of presentation, 12.5% of patients have one n [4].

Serology, cell culture, enzyme immunoassay (quick antigen detection test), and real-time polymerase chain reaction can all be used to detect RSV, although most of these techniques are time-consuming and ineffective. Due to the fact that all adult RSV infections are reinfections, serology (IgM and IgG) is useless. In order to determine an acute infection, two blood samples must be obtained that show a 4-fold increase in serum antibody. Given the lability of the virus, the length of time required for a conclusive diagnosis (days to weeks) and the diagnostic insensitivity (17–39%), diagnosing RSV by culture is not recommended. Finally, because the sensitivity of fast antigen testing is often less than 10%, they are not generally advised for correct diagnosis in adults. The gold standard is the reverse transcription polymerase chain reaction (RTPCR) [5].

84–100% sensitivities are used in a common approach for identifying acute RSV infection. The importance of gathering a sufficient sample cannot be overstated, with nasopharyngeal swabs showing to be more accurate than oropharyngeal swab specimens. Since viral replication is higher in the lower respiratory tract in advanced stages of sickness, lower respiratory samples are chosen for intubated patients. Regardless of the technique, RSV-related illness in adults is still difficult to diagnose accurately. Accurate identification requires numerous procedures or sample sites, as well as maintaining a high index of suspicion. It is crucial to note that many clinicians choose not to look for RSV as a probable aetiology of their patient's symptoms because there are currently no effective treatments for RSV only a few effective treatment options [6-10].

Conclusion

Clinicians frequently ignore RSV's role in adult morbidity and mortality. RSV is associated with around 250,000 deaths annually, excluding children. Despite significant advancements in their understanding of the impact of RSV-related sickness in adults, researchers and epidemiologists still have much to learn. For instance, there is a dearth of information about RSV in underdeveloped nations. There are no research on the prevalence of RSV in any emerging nation. The implications of LRIs are typically greater in older persons in underdeveloped nations, which is problematic when creating worldwide estimates of illness burden. This gap is mostly caused by the communities' poorer socioeconomic condition, dependence on solid fuels, undernutrition, immunological dysfunction, and malnourishment. Additionally, describing the prevalence of RSV-related illness in Obtaining precise data on the incidence, hospitalisation rate, and hospital mortality rates of RSV-infected individuals in poor countries is essential. RSV infection is actually associated with worse outcomes and greater resource use than influenza illness, despite the fact that influenza has traditionally gotten more attention due to its higher incidence and the related ease of detection. Our comprehension of the significance of RSVassociated disease is likely to increase as awareness of it does.

References

  1. Falsey, Ann R., Coleen K. Cunningham, William H. Barker and Ruth W. Kouides et al. "Respiratory syncytial virus and influenza A infections in the hospitalized elderly." J Infect Dis 172 (1995): 389-394.

    2. Google Scholar, Indexed at, Crossref

  2. Falsey, Ann R., Patricia A. Hennessey, Maria A. Formica and Edward E. Walsh et al. "Respiratory syncytial virus infection in elderly and high-risk adults." N Engl J Med 352 (2005): 1749-1759.

    3. Google Scholar, Indexed at, Crossref

  3. Glezen, W. Paul, Larry H. Taber, Arthur L. Frank and Julius A. Kasel. "Risk of primary infection and reinfection with respiratory syncytial virus." Am J Dis Child 140 (1986): 543-546.

    4. Google Scholar, Indexed at, Crossref

  4. Lieberman, David, Avi Shimoni, Yonat Shemer-Avni, and Ayelet Keren-Naos et al. "Respiratory viruses in adults with community-acquired pneumonia." Chest 138 (2010): 811-816.

    5. Google Scholar, Indexed at, Crossref

  5. Widmer, Kyle, Yuwei Zhu, John V. Williams and Marie R. Griffin et al. "Rates of hospitalizations for respiratory syncytial virus, human metapneumovirus, and influenza virus in older adults." J Infect Dis 206 (2012): 56-62.

    6. Google Scholar, Indexed at, Crossref

  6. Barnes, Michelle, Anita E. Heywood, Abela Mahimbo and Bayzid Rahman et al. "Acute myocardial infarction and influenza: A meta-analysis of case–control studies." Heart 101 (2015): 1738-1747.

    7. Google Scholar, Indexed at, Crossref

  7. Moyes, Jocelyn, Sibongile Walaza, Marthi Pretorius and Michelle Groome et al. "Respiratory syncytial virus in adults with severe acute respiratory illness in a high HIV prevalence setting." J Infect 75 (2017): 346-355.

    8. Google Scholar, Indexed at, Crossref

  8. Shorr, Andrew F., Kristen Fisher, Scott T. Micek and Marin H. Kollef. "The burden of viruses in pneumonia associated with acute respiratory failure: An underappreciated issue." Chest 154 (2018): 84-90.

    9. Google Scholar, Indexed at, Crossref

  9. Mehta, Jyotsna, Edward E. Walsh, Parthiv J. Mahadevia and Ann R. Falsey. "Risk factors for respiratory syncytial virus illness among patients with chronic obstructive pulmonary disease." J Chronic Obstr Pulm Dis 10 (2013): 293-299.

    10. Google Scholar, Indexed at, Crossref

  10. Lozano, Rafael, Mohsen Naghavi, Kyle Foreman and Stephen Lim et al. "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the global burden of disease study 2010." lancet 380 (2012): 2095-2128.

    11. Google Scholar, Indexed at, Crossref

Author Info

1Department of Medicine, Medstar Washington Hospital Center, Washington, DC 20010, USA
 

Received: 01-Sep-2022, Manuscript No. jidm-22-79845; Editor assigned: 03-Sep-2022, Pre QC No. P-79845; Reviewed: 17-Sep-2022, QC No. Q-79845; Revised: 23-Sep-2022, Rev Manuscript No. R-79845; Published: 01-Oct-2022, DOI: 10.37421/2576-1420.2022.7.258

Citation: Busack, Andrew. “As the Adult Respiratory Virus That Goes Unnoticed, RSV” J Infect Dis Med 7 (2022): 258.

Copyright: © 2022 Busack A. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.