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RSV can have serious impact on elderly, immunosuppressed adults, says infectious disease expert

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As Canadian hospitals deal with a wave of children infected with respiratory syncytial virus (RSV), concern has grown about how the virus could also impact adults.

Young children, especially those under the age of four, have been most affected by RSV in recent weeks as hospitals have reported kids and infants arriving with high fevers or difficulty breathing. Additionally, a supply shortage of children's pain relievers has exacerbated long wait times for health care as parents flock to emergency rooms in search of aid for their children.

Now, doctors are concerned about the risk RSV can pose to seniors and other vulnerable adults.

Dr. Sumon Chakrabarti, an infectious disease physician at Trillium Health Partners in Mississauga, Ont., says RSV can show up in adults but it typically only has serious effects on seniors, those with chronic pre-existing conditions such as lung disease or adults who have a severely suppressed immune system due to cancer, for example.

"RSV can manifest in a person who's older and brittle and it makes them feverish, they get dehydrated, they get short of breath, and then they get admitted to hospital," Chakrabarti said in an interview with CTVNews.ca on Saturday.

As of Nov. 18, there have been 1,944 reported cases of RSV, maintaining the seven per cent positivity rate seen consistently since early November. While the data doesn't separate RSV infections by age group, the overall number of cases has been stabilizing, according to Canada's latest respiratory virus report.

For the vast majority of adults, RSV can present like a regular cold so they may not even realize they have the virus, said Chakrabarti.

"We've all been exposed to it multiple times and the thing is, it's indistinguishable from a cold," he said. In the majority of adults, it usually isn’t severe, he said.

Most adults have already been exposed to RSV before the COVID-19 pandemic, said Chakrabarti, and their immunity is stronger than that of an infant or an older adult with a weak immune system.

"A kid that is less than six months of age, or kids who haven't seen RSV at all in the last two and a half years, they were more susceptible because there's absolutely no immunity to it and that's why we saw what we did,” he said.

ALLEVIATING THE STRAIN ON THE HEALTH-CARE SYSTEM

According to Dr. Dale Kalina, an infectious disease physician with Joseph Brant Hospital in Burlington, Ont., RSV is found in six to eight per cent of adults over the age of 50 who have been hospitalized for respiratory illness.

Kalina said while he has yet to see severe adult hospital admissions with RSV this season, there have been more cases of children passing RSV along to their caregivers, in addition to other respiratory viruses.

"It is still spreading, both rhinovirus and RSV, and the flu and just the numbers of people that we're seeing with all of these respiratory viruses, particularly so early in the season, it is concerning," he told CTVNews.ca in a phone interview on Monday.

Though the wave of infected children with RSV is slowing down, Kalina said it's important to continue regular health practices to combat the spread of other viruses and help alleviate the strain on the already overwhelmed health-care system.

"It's not an isolated virus. It's something that's circulating in our community, and helping in one area will help others areas in the health-care system too," he said.

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