Efforts need to be made to educate older adults of the risk of the disease

What is going on with the nasophage? The COVID-19 pandemic leads to more deaths and hospitalizations of children and elderly people

A spike in respiratory syncytial virus (RSV) can be traced to a return to social activity during the COVID-19 Pandemic. The virus usually causes a mild illness with nothing more than cold-like symptoms, but these lower respiratory tract infections can come with severe and devastating consequences for some children and elderly people. RSV is the most common cause of bronchiolitis in children under the age of two. Roughly one-quarter of people admitted to hospital with RSV will require intensive care — and 6.6% of those who are hospitalized will die.

When a retired physician in his early 80s was admitted to a New York hospital with serious breathing problems, his doctors suspected that his previous heart failure had caused the problem. He was given a variety of drugs to try to lower his blood pressure. The medications did not make a difference. His doctors were stumped.

Fortunately, the patient recovered on his own, but his story is “a great example” of a broader, problematic trend in medicine, says Ann Falsey, a physician who specializes in infectious diseases at the University of Rochester Medical Center in New York and who works closely with Walsh. “People just don’t even consider an RSV diagnosis in adults.”

There have been very few studies done outside of the United States. In high-income countries, about 787,000RSV hospitalizations and 22,000 deaths in people over the age of 65 were counted by Nair and his colleagues. These figures turned out to be about 2.2 times higher than previous estimates.

As a result, nasal-swab-based rapid antigen tests for identifying RSV in adults “are nearly useless”, Falsey says. She says that most adults do not have enough viral particles in their nose to generate a positive test result.

The good news on the awareness front is that some multiplex PCR tests now automatically include flu, RSV and SARS-CoV-2. Physicians and hospitals have also stepped up their viral testing in general since the pandemic. People will come to me now and say ‘My goodness!’ What is happening with the vehicle? It’s in all my old people!’” Falsey is correct. I was like, ‘There is nothing going on and you are testing.’

Furthermore, biotechnology company Moderna in Massachusetts is developing an mRNA-based RSV vaccine, and Bavarian Nordic, a biotechnology company based in Hellerup, Denmark, is creating an adenovirus vector RNA vaccine. “We’re probably going to be spoiled for choice,” Nair says.

We are pleased to acknowledge the financial support of Moderna in producing this Outlook. Nature is sole responsibility for all editorial content.

Towards a Sustainable Development of Low-Income Countries: The Challenges of Interventions for the First-Infrared Population

Even though there are some things that engender optimism, substantial hurdles remain. People living in low-income countries are more vulnerable due to the disparity of access to existing interventions. Without policies in place, the communities could be left exposed.

Efforts to prevent infections and keep vulnerable people out of hospital are beginning to pay off, but deploying these strategies presents new challenges.

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