We Need a 'Surge' in RSV Awareness

COVID-19 has been an ever-present part of our lives since 2020 and has altered nearly all the ways in which we interact with the world and with one another.

The pandemic has also led to an overall increase in awareness of respiratory disease as we’ve not only considered our own health, but also increasingly cared about the well-being of those around us. At the same time, however, social distancing and other measures we took to fight COVID-19 resulted in a marked absence of the seasonal surges of other respiratory infections – namely diseases caused by influenza and respiratory syncytial virus (RSV).¹

In a July 2021 report from the U.S. Centers for Disease Control and Prevention (CDC), officials warned that we could see spikes in other respiratory infections as COVID-19 mitigation practices become less stringent, and that prediction has proven true. A recent uptick in RSV cases in the United States earlier in 2021 prompted the CDC to recommend broader testing for RSV, particularly among individuals who test negative for SARS-CoV-2, the virus that causes COVID-19.² Researchers have also hypothesized that we could see an epidemic in Europe outside the usual autumn/winter season, which could be larger than typically expected.³

But despite public knowledge of COVID-19 and the flu, RSV is far less known, particularly in adults, even though it is a leading cause of bronchitis and pneumonia⁴ and can be particularly dangerous.

Diagnosis Critical to Saving Lives
RSV is an RNA virus that primarily spreads through respiratory droplets, such as when a person coughs or sneezes, and through direct contact with a contaminated surface.³ Common symptoms of RSV include fever, congestion, and cough. The virus starts as an upper respiratory infection, like the common cold, and with similar symptoms.

However, if RSV progresses to the lungs, known as the lower respiratory tract, it becomes a more severe condition, and may cause fever, a severe cough, wheezing, rapid or difficulty breathing, and a bluish color of the skin called cyanosis due to lack of oxygen.⁴ This is particularly troublesome for young infants, older adults, the immunocompromised, and adults with lung or heart disease.⁵

RSV, COVID-19, and influenza infections can easily be mistaken for one another when judging by symptoms alone. Therefore, it is critical that physicians are aware of the increased circulation of RSV, now at times of the year not usually expected. The CDC has encouraged clinicians to incorporate broader testing for RSV when seeing patients with acute respiratory illness who test negative for SARS-CoV-2.¹ While there are currently no vaccines or treatments available for RSV, it is important to remember that we can avoid spreading RSV to other, more vulnerable people by adhering to the same mitigation practices used to minimize the spread of COVID-19.

Millions of Lives Impacted
RSV remains a major global public health concern and a cause of serious respiratory illness in all age groups. In a typical year, between three and seven percent of older adults (aged 60 and above) and four to 10 percent of high-risk adults (aged 18 and above) experience RSV. Because complications can include pneumonia or the exacerbation of underlying conditions such as asthma, chronic obstructive pulmonary disease (COPD), and congestive heart failure, up to 50 percent of high-risk adults with symptomatic RSV infection need to visit a doctor.⁶

Further, an estimated 33 million children worldwide under the age of five are infected with RSV in a typical year. Approximately 70 percent of all acute bronchiolitis hospitalizations in children, as well as up to 30 percent of community-acquired pneumonia cases requiring hospitalization, are due to RSV.^7,8,9 Additionally, up to 60 percent of all children with RSV infections require medical assistance, with up to 10 percent of these children admitted to the hospital.^10,11

Our Commitment to Pioneering Solutions
At Janssen, we have a deep heritage of caring for those affected by respiratory infections. We combine our passion for innovative science with the goal of reducing the serious impact of respiratory infections including RSV, COVID-19, and influenza. As part of that effort, we are building a deep understanding of the transmission and pathogenesis of RSV to pioneer solutions to protect and treat those most vulnerable.

Our pipeline aims to bring forward potential vaccine and treatment options for RSV to those in greatest need.

Protecting the Most Vulnerable
As we look ahead to the innovative treatment and prevention approaches so urgently needed, it is critical now to raise awareness of the burden of RSV, and to increase its diagnosis.

For older adults, high-risk adults, and caregivers of young children especially, it is important to familiarize oneself with the signs and symptoms of RSV infection and seek medical care for any severe symptoms.

For medical professionals, it will be particularly important this year and moving forward to test for RSV along with the flu and COVID-19 to ensure accurate, differential diagnosis and to determine appropriate treatment.

And for the scientific community, it remains critical that we continue our work in developing potentially life-saving treatments and vaccines for RSV. Only together can we improve the outcome of respiratory infections for those most vulnerable. Together, we can help improve the health of the global population.

October 1, 2021

¹ CDC. Changes in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic — United States, 2020–2021. https://www.cdc.gov/mmwr/volumes/70/wr/mm7029a1.htm?s_cid=mm7029a1_w. Last accessed: September 2021.
² CDC. Increased Interseasonal RSV Activity in Parts of the Southern United States. Available at: https://emergency.cdc.gov/han/2021/han00443.asp. Last accessed: September 2021.
³ Van Summeran, J., et all. Low levels of respiratory syncytial virus activity in Europe during the 2020/21 season: what can we expect in the coming summer and autumn/winter?. Eurosurveillance.2021; 26(29): 2100639.
⁴ National Institute of Allergy and Infectious Diseases. Respiratory syncytial virus (RSV). Available at: https://www.niaid.nih.gov/diseases-conditions/respiratory-syncytial-viru.... Last accessed: September 2021.
⁵ Centers for Disease Control and Prevention. Respiratory Syncytial Virus Infection (RSV). Available at: https://www.cdc.gov/rsv/index.html. Last accessed: September 2021.
⁶ Falsey AR, Hennessey PA, Formica MA, et al. Respiratory syncytial virus infection in elderly and high-risk adults. N Engl J Med. 2005;352(17):1749-1759.
⁷ Shi T, McAllister DA, O’Brien KL, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017;390(10098):946-958.
⁸ Coultas JA, Smyth R, Openshaw PJ. Respiratory syncytial virus (RSV): a scourge from infancy to old age. Thorax. 2019;74:986-993.
⁹ Jain S, Williams DJ, Arnold SR, et al. Community-Acquired Pneumonia Requiring Hospitalization among U.S. Children. N Engl J Med. 2015;372:835-845.
¹⁰ RESCEU Birth Cohort Study. Data on file.
¹¹ Hall CB, Weinberg GA, Iwane MK, et al. The Burden of Respiratory Syncytial Virus Infection in Young Children. N Engl J Med. 2009;360:588-598.