Wednesday, September 06, 2023

CDC HAN #00498: Increased Respiratory Syncytial Virus (RSV) Activity in Parts of the Southeastern United States



Recent Uptick in ILI Activity In The Southeastern U.S.

#17,658

While it is only the first week of September we are already seeing sporadic reports of respiratory infections around the nation (see FluView chart above). Although a lot of this may be due to a recent rise in COVID cases (see CDC chart below), RSV and influenza are also part of the mix.


RSV in most healthy adults produces mild, cold-like symptoms - but for young children and older adults (particularly with commodities) - it can produce severe, sometimes fatal, illness.  The CDC describes it as:

Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious. Infants and older adults are more likely to develop severe RSV and need hospitalization. Vaccines are available to protect older adults from severe RSV. Monoclonal antibody products are available to protect infants and young children from severe RSV.

Prior to this year there were no approved pharmacological tools to prevent RSV, but earlier this summer the FDA approved an RSV Monoclonal Antibody for Infants and Young Children and last May the FDA approved the first RSV vaccine for older adults.

With new pharmacological options available, and RSV rising - particularly in the Southeastern United States - the CDC issued a HAN Advisory yesterday for clinicians, and the public. 

Due to its length, I've only posted the summary and the recommendations for the public. Clinicians and others with an interest in the more technical details will want to follow the link to read it in its entirety.


Increased Respiratory Syncytial Virus (RSV) Activity in Parts of the Southeastern United States: New Prevention Tools Available to Protect Patients

Distributed via the CDC Health Alert Network
September 05, 2023, 2:00 PM ET
CDCHAN-00498


Summary

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify clinicians and caregivers about increases in respiratory syncytial virus (RSV) activity across some parts of the Southeastern United States in recent weeks, suggesting a continued shift toward seasonal RSV trends observed prior to the COVID-19 pandemic. Historically, such regional increases have predicted the beginning of RSV season nationally, with increased RSV activity spreading north and west over the following 2–3 months. RSV can cause severe disease in infants, young children, and older adults.

In anticipation of the onset of the 2023-2024 RSV season, CDC encourages clinicians to prepare to implement new RSV prevention options. Monoclonal antibody products, including a new, long-acting product, nirsevimab (BeyfortusTM, Sanofi and AstraZeneca), are available to protect infants and some young children at higher risk for severe RSV disease. For all infants ages <8 months, and infants and children ages 8–19 months who are at increased risk of severe RSV, clinicians should start to offer nirsevimab when it becomes available (expected by early October).

Also, two new vaccines are available to protect older adults from severe RSV disease. For adults ages 60 years and older, clinicians should offer a single dose of an RSV vaccine, either RSVPreF3 (Arexvy, GSK) or RSVpreF (AbrysvoTM, Pfizer), based on shared clinical decision-making between the healthcare provider and the patient. Clinicians should also talk to their patients about other vaccines available this fall to help prevent respiratory infections. Clinicians should consider testing symptomatic patients with high-risk conditions for COVID-19, influenza, and RSV to inform treatment decisions. Healthcare personnel, childcare providers, and staff at long-term care facilities should stay home and not go to work when they have fever or symptoms of respiratory infection to reduce the spread of respiratory infections including RSV.

(SNIP)
Recommendations for the Public
  • Expectant parents, parents of infants under the age of 8 months, and parents with older babies (through age 19 months) at increased risk of severe RSV disease should talk with their healthcare providers about using monoclonal (preventive) antibodies to protect against RSV this season. Infants under the age of 8 months should receive preventive antibodies to protect against RSV this season.
  • Adults ages 60 years and older should talk to their healthcare provider about whether RSV vaccination is appropriate for them.
  • Stay home and away from others when you are sick. If you are at increased risk of severe illness, contact your healthcare provider to see if you would benefit from early diagnostic testing. Treatments for influenza and COVID-19 are available that, if given within days of symptoms starting, can reduce your risk of hospitalization and death.

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