Respiratory Syncytial Virus (RSV) has long been recognized as a primary cause of respiratory illness in infants and young children.

However, emerging evidence reveals that RSV poses a significant health threat to adults as well—particularly older adults and those with underlying conditions.

RSV in Adults: An Underestimated Threat

While RSV is often associated with pediatric infections, recent large-scale studies demonstrate that adults, especially those aged 60 and above, experience substantial morbidity and mortality from RSV infections.

A comprehensive cohort study involving over 5,000 adults diagnosed with RSV-associated acute respiratory infection (RSV-ARI) found that these patients face a 2.7-fold higher risk of death within one year compared to the general population.

Dr. Ann R. Falsey, Professor of Medicine and Infectious Disease specialist, emphasized "Respiratory syncytial virus (RSV) is an increasingly recognized cause of illness in adults."

The Burden of RSV Hospitalizations in Older Adults

Hospitalization rates for RSV increase markedly with age. Surveillance data spanning a decade in multiple hospitals across Europe indicate that approximately 1 in every 1,000 adults aged 60 years and older is hospitalized annually due to RSV infection. The incidence rises steeply in those over 80, underscoring the vulnerability of the elderly population.

Notably, standard case definitions based on influenza-like illness (ILI) tend to underestimate RSV hospitalizations by up to 40%, suggesting that the true burden is even greater than reported. This discrepancy has prompted the World Health Organization to update surveillance criteria to better capture severe RSV cases in adults.

High-Risk Groups Beyond the Elderly

RSV does not exclusively threaten the elderly. Adults aged 18 to 59 with chronic medical conditions such as chronic obstructive pulmonary disease (COPD), asthma, diabetes, or immunocompromising disorders also face elevated risks of severe RSV disease and hospitalization. For example, adults with COPD experience RSV-related exacerbations 3.1 times more frequently than those without, while asthma patients have a 4.6-fold increase.

Economic and Healthcare Impact

The consequences of RSV in adults extend beyond health outcomes. The study highlighted that RSV-ARI patients incurred healthcare costs averaging over 20,000 EUR within one year post-infection, more than double the costs for matched controls without RSV. Increased hospitalizations, intensive care admissions, and prolonged recovery periods contribute to this substantial economic burden.

Advances in Prevention: New Vaccines on the Horizon

The recognition of RSV's impact on adults has accelerated vaccine development. Recent approvals and ongoing trials focus on vaccines tailored for older adults and high-risk populations, aiming to reduce hospitalizations and severe disease. These innovations represent a pivotal shift in public health strategy, moving beyond pediatric prevention to encompass adult populations.

RSV is far from a childhood-only illness. Its significant morbidity, mortality, and economic costs in adults particularly the elderly and those with chronic conditions—demand greater clinical awareness and public health attention. As Dr. Michelle Barron states "It's wonderful anytime we can prevent a disease from becoming severe, and preventing hospitalizations is definitely worthwhile."