The RSV season is only beginning to subside, but it is already clear: this year’s wave of illnesses caused by the respiratory syncytial virus was at least as severe as in 2022/23 and also as in the years before the corona pandemic. This is confirmed by Bernhard Resch from the Department of Neonatology at MedUni Graz: “In principle, we had the same schedule as before Covid-19, but very, very many admissions and assignments to the children’s intensive care unit.”
There were many hospital admissions and severe cases, both among infants and senior citizens, according to a report from the Austrian Association of Vaccine Manufacturers (ÖVIH). The season was postponed slightly to the beginning of the year compared to immediately after the pandemic and ran at the same time as the influenza epidemic. Most hospital admissions were recorded at the beginning of February, when the positive rate of the samples sent in was 20 percent – from ten percent onwards an epidemic situation is assumed: After a few RSV-related hospital stays in October, the admissions increased to more than 450 in just one week in February, including 13 in intensive care.
Resch described the case of a premature baby who had become infected in the hospital: “The infant’s condition deteriorated massively after just a few hours, even though he was actually about to be discharged. The boy was taken to the children’s intensive care unit and had to be intubated for two weeks and ventilated. He then had to stay in the intensive care unit for weeks, while the unaffected twin sister had been at home for five weeks.” A seven-month-old baby even died in Vienna.
RSV often presents as a “cold” in adults
In working-age adults, RSV usually presents as a “cold” with cough and runny nose. In older people, bronchitis, pneumonia and worsening of existing heart and lung diseases can occur. According to ÖVIH, there are around 145,000 hospitalizations due to RSV in people over 65 in the EU each year, 2,300 of them in Austria.
According to Stefan Winkler, deputy. Head of the Clinical Department for Infections and Tropical Medicine at MedUni Vienna, RSV and influenza are now equally problematic for older people. “Many are sick all winter now. First they have Corona, which weakens their immune system. Then – because many are unvaccinated – they get influenza, and then RSV.” An RSV infection can be life-threatening, especially for people with a previous lung disease.
Vaccines for seniors and pregnant women have been available since autumn 2023. According to the ÖVIH, the two vaccines for people over 60 have shown high effectiveness against severe RSV in the approval studies, and one is also approved for pregnant women. The mother’s antibodies are transferred to the unborn child via the placenta. In Austria, there is passive immunization for “at-risk infants” that must be administered once a month. A long-acting RSV monoclonal antibody is already approved at EU level and is given only once per season. Discussions are underway in Austria. Another long-acting monoclonal RSV antibody is still in development.
There are therefore options “to reduce the disease burden caused by RSV in Austria. They just have to be used accordingly,” says the ÖVIH. However, the RSV vaccines, which were available for the first time last year, have to be paid for by yourself and cost well more than 200 euros.