What is Respiratory Syncytial Virus (RSV)?

RSV is a highly infectious respiratory tract virus. It is recognised as one of the most common causes of respiratory tract infections in children and adults. In one USA study, it was identified as the causative organism in at least 12% of older adults who sought medical attention. The disease has a wide spectrum of symptoms, from very mild to severe.

RSV circulates in the community during the winter months in temperate climates and during the hot humid months of the wet season in tropical areas.

Two types (A and B) have been identified. Only one seems to predominate in any season.

The disease has high rates of hospital admission in high-risk groups.

Respiratory Syncytial Virus is a notifiable disease in Australia.

More than 130,000 cases of RSV have been reported over the last 12 months (to March 2024) in Australia with 55,000 cases recorded between June and September 2023 (winter months).

How is RSV transmitted?

The disease is transmitted through large droplet infection. It is acquired through touching contaminated surfaces and then self-inoculation. The virus can survive on hard surfaces for many hours. It is less likely to be transmitted by aerosol, but it is possible within a short distance (under 1.5 metres).

Those infected with RSV are contagious from 1-2 days before showing symptoms and for a few days afterwards.

Most children have experienced their first infection by 2 years of age. It is usually picked up outside the home – in childcare centres and school.

Transmission within healthcare facilities is common.

Repeat infections are common at any age.

Who is at risk of serious RSV disease?

Most people will experience a mild illness with RSV disease. Those most at risk of serious disease include very young children (under 5 years), older individuals (> 65 years), and people who might be Immune suppressed.

Approximately 2-3% of infants with RSV will require hospitalisation.

Co-morbidities such as asthma, chronic lung disease and heart failure may also contribute to more serious disease and hospitalisation.

Studies undertaken in the USA estimate that RSV is responsible for 60,000 to 160,000 hospitalisations annually and between 6,000 and 10,000 deaths in people over 65 years.

How is RSV prevented?

Non vaccination

Most respiratory viruses can be avoided by simple measures.

• Hand washing
• Avoiding close contact with sick people, particularly children
• Avoid touching your face with unwashed hands
• Keeping surfaces clean

Vaccination

Respiratory Syncytial Virus (RSV) vaccine is now available.

Arexvy (GSK) is the only RSV vaccine registered for use in Australia and available under private prescription. It is important to understand it is NOT funded under the National Immunisation Program (NIP) currently. The vaccine is approved for use in those over 60 years.

Arexvy is recommended for:

• All individuals over 75 years
• Individuals 60 -74 years with medical conditions that increase the risk of severe RSV disease.
• First Nation adults aged 60 – 74 years.
• Anyone over 60 years who feels at high risk of exposure (grandparents, childcare workers, teachers etc).

Abrysvo (Pfizer) is registered for use in Australia but not currently available. It is also recommended for those over 60 years.

When is the best time to be immunised?

It is best to have the vaccine before the season of risk (autumn and winter).

Is the RSV vaccine an annual vaccine like the flu?

No. It is not an annual vaccine currently. It is likely to be protective for at least 2 seasons. More will be known about the length of protection in the next few years.

What is the level of protection?

In one large study the vaccine was shown to reduce symptomatic lower respiratory tract disease by more than 80% in the first year and over 55% in the second year.