2023-05-08 08:05:00
A doctor alerted us in mid-November to a possible “Kiss Cool double effect”. “The secondary problem of RSV is that babies infect seniors, who experience respiratory distress. These three letters designate the respiratory syncytial virus, the cause of bronchiolitis which affects many infants each year. It is less known, but the elderly or immunocompromised can also suffer the consequences. A first vaccine against RSV infections has also just been approved for seniors, in Europe and then in the United States.
In the adult intensive care unit of the Lariboisière hospital, in Paris (Xe), “when we had the triple epidemic this winter, RSV was in the lead”, testifies Bruno Mégarbane, head of the unit. Among the patients cared for throughout the winter season, “a large third had RSV, a small third the flu and another small third the Covid”, assesses the doctor. “Toddlers remain the most affected by this virus, but this is no reason to forget that there can be RSV infections in the elderly”, urges doctor Renaud Marin La Meslée, president of the union. National General Practitioners and Geriatricians working in nursing homes.
Decompensations of chronic diseases
These seniors can have pneumonia following an RSV infection, but also – and often – decompensation of a pre-existing chronic disease (cardiac, respiratory, etc.). “I don’t spend a call without seeing an elderly person who is decompensating because of an RSV”, testified at the end of November an emergency doctor. Healthy young adults run almost no risk of a serious form if they catch this virus, which circulates mainly in winter and is transmitted mainly by aerosol, droplets or postilions.
The figures across Europe speak for themselves: 250,000 people aged 65 and over are hospitalized each year as a result of an RSV infection and 17,000 die from it, according to estimates by the European Medicines Agency. Across the Atlantic, estimates range from 60,000 to 120,000 hospitalizations and 6,000 to 10,000 deaths per year in this same age group. In the United Kingdom, up to 16 hospitalizations following an RSV infection per 100,000 inhabitants aged 85 and over were recorded in one week at the end of December.
Improving screening
To say that an elderly or very fragile person has been infected with this virus, it is still necessary to know it. However, the usual symptoms are nothing special compared to the flu and Covid: fever, cough, runny nose, sneezing, etc. Only screening can tell them apart. At the hospital, in winter, “every patient who enters is tested for three viruses”, testifies Professor Mégarbane. On the other hand, very few tests are carried out in town (doctor, pharmacy, laboratory, etc.) or in nursing homes.
Several biologists are pleading to intensify the triple screening for Covid, influenza and RSV next winter, in particular on symptomatic elderly people. “We found ourselves very active on the Covid and perhaps not enough on other viruses. We should probably rebalance things a little, ”according to Stéphanie Haim-Boukobza, director of medical affairs for the Cerballiance group. This strategy would make it possible to make a precise diagnosis and to adapt the treatment, even if there is no specific drug against RSV.
By then, a first vaccine, that of the industrialist GSK, could therefore soon arrive on the market. After the European authorization, the High Authority for Health will now have to decide for the French market. The body has planned to look into “the development of a strategy for the prevention of RSV” at the start of the school year, she tells us. Should the vaccine be recommended for all older people, or only for some of them? How often will it be necessary to vaccinate, one booster per year as against the flu? Renaud Marin La Meslée recognizes this: “For the moment, we don’t know anything about it. »
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