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Respiratory Syncytial Virus (RSV)

What is Respiratory Syncytial Virus (RSV)?

The Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infections, responsible for yearly outbreaks starting late fall to early spring. RSV impacts infants, young children, and older adults. All infants entering their first RSV season are at risk of RSV infection because they have no built-up immunity.  

RSV is transmitted directly or indirectly by respiratory droplets. 

  • Direct transmission: Respiratory droplets from coughs or sneezes of an infected person come into contact with the mucus membranes (of the eyes, nose, mouth, or airway) of another person. 
  • Indirect transmission: Respiratory droplets are introduced to the body after touching contaminated surfaces or objects and then one’s eyes and/or mouth. 

 

Baby boy age about 1 year old sleeping on patient bed with getting oxygen via nasal prongs to assure oxygen saturation. Intensive care at hospital. Respiratory support.

 How does RSV affect people with Asthma? 

RSV is particularly concerning for people with asthma, as it can worsen asthma symptoms and trigger asthma attacks. Children with asthma or a history of wheezing are at an increased risk of severe RSV-related complications, such as bronchiolitis or pneumonia, which can lead to hospitalization. Even in adults, RSV infections may worsen existing asthma symptoms or lead to a more severe asthma attack. 

For children with asthma, severe RSV can be unpredictable and a leading cause of hospitalizations in infants. Know the signs and symptoms (most often irritability, cough, sneezing, runny nose, fever and decreased appetite) which can be similar to a mild cold. If the symptoms show up and do not clear up in a few days, contact your child’s healthcare provider.  

A barking or wheezing cough or more difficulty breathing may be a sign of serious illness. The virus may be spreading to the lower respiratory tract and causing inflammation of the small airways and may lead to pneumonia or bronchiolitis. 

In adults, RSV infections can worsen asthma symptoms, lead to more severe asthma attacks, and possible hospitalization. The risk of severe respiratory issues and asthma exacerbations is increased in adults with asthma and other comorbidities like Chronic Obstructive Pulmonary Disease (COPD) or a weakened immune system. 

Managing RSV and Asthma 

In children and adults with asthma, the key to managing RSV is proactive asthma care. This includes keeping asthma symptoms well-controlled with regular medications, using inhalers correctly and as prescribed, and avoiding triggers that can worsen respiratory issues. If RSV infection occurs, it is essential to monitor symptoms closely, and to seek medical attention promptly, especially if there are signs of severe respiratory distress. 

RSV Prevention Tips for People with Asthma 

    • Hand hygiene: Wash hands frequently with soap and water to prevent the spread of RSV. Avoid sharing cups or toys. Stay home when you are sick. Clean frequently touched surfaces. 
    • Avoid contact: Avoid crowded places during RSV season. Avoid close contact with people who have cold-like symptoms or confirmed RSV. Wear masks in high-risk environments such as healthcare settings.  
    • Vaccination: Ensure that children and adults at higher risk of complications receive RSV preventive treatments. 
    • Asthma management: Ensure that asthma is well-controlled.  Untreated asthma increases the risk of severe respiratory complications. 

    Why get vaccinated against RSV? 

    There is no cure for RSV. Vaccination is essential to reduce the impact of RSV, prevent severe disease, and to protect people at high risk of complications from the virus. Infants, children, and adults with chronic lung diseases such as asthma, COPD, cystic fibrosis or any condition that affects one’s ability to clear airway secretions are all in that high-risk category. 

    How do RSV vaccines work? 

    An inactivated RSV protein is introduced into your body. It then causes an immune response. The body develops antibodies that help prevent severe illness including pneumonia if later exposed to RSV.  

    Types of RSV vaccines available in Canada  

    Health Canada has authorized two vaccines, both based on the prefusion stabilized F protein (preF), to protect adults from RSV. The vaccines are given in a single dose and stimulate the immune system to produce antibodies to protect against severe RSV infections and complications including pneumonia. 

    AREXVY (RSVPreF3) RSV subunit adjuvanted vaccine.  

    Arexvy is recommended for: 

    • Adults aged 50-59 years at increased risk for RSV disease 
    • Adults aged 50 and older with a history of chronic conditions, including diabetes, asthma, chronic obstructive lung disease and hear failure.  
    • Adults 75 years and older and those aged 60 and above in nursing homes and other chronic care facilities.  
    • Adults aged 60-74 years may consider RSV vaccination but should consult their health care provider. 

    ABRYSVO (RSVpreF) RSV subunit vaccine.  

    Abrysvo is recommended for: 

    • Adults 60 years of age and older. 
    • Pregnant individuals from 32 through 36 weeks gestational age to prevent lower respiratory disease in infants from birth to six months of age. 

    In infants, the RSV monoclonal antibody (Nirsevimab) is preferred over palivizumab and the RSVpreF vaccine (Abrysvo) vaccine. Nirsevimab is prioritized for infants who were born prematurely as well as for infants and children with chronic diseases, including lung disease requiring ongoing assisted ventilation, oxygen therapy, or chronic medical therapy in the six months prior to the start of the RSV season. 

    Useful Resources:

    Little girl receiving vaccine from doctor

    Asthma and Vaccines

    People with asthma face a higher risk of serious illness from preventable diseases, making vaccination extremely important.

    Lung Vaccination Working Group

    Within Canada, vaccine uptake continues to be a significant area of concern.

    Asthma Control Toolkit

    Controlling Asthma

    When asthma is unmanaged, it can put a pause on your life. Learn how to break breathlessness and press play on life.

    Asthma Canada's FREE Asthma & Allergy HelpLine

    If you have questions on managing your asthma and vaccines, please contact our free HelpLine at 1-866-787-4050 or info@asthma.ca. Our team of asthma and allergy experts will happily assist you with your asthma control and help put your mind at ease.

    Jaqueline Murdoch: Asthma and Vaccine Champion

    Jaqueline Murdoch, 75, a retired IT manager and personal trainer, is a passionate advocate for vaccination, shaped by a lifetime of health challenges and early experiences with preventable diseases. Diagnosed with asthma in 2012, she manages her condition with a rigorous health routine and proactive vaccination. Jaqueline received all available COVID-19 doses, annual flu shots, and vaccines for shingles and pneumonia, seeing immunization as essential to reducing severe illness. Having witnessed the impact of diseases like polio and shingles, she urges others to “look at the science” and stay informed, firmly believing that vaccines are key to a long, healthy life.