RSV surge raises questions about recurrence: Can you or your child get it again?

As the respiratory syncytial virus, also known as RSV, continues to rise in the United States, experts warn that people can be infected with it more than once.

Dr. Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau Hospital on Long Island, New York, told Fox News Digital this week, “A person can get RSV more than once in their lifetime.”

A second infection is unlikely to occur immediately after a recent episode. Still, it can infect someone more than once in the same season, especially immunocompromised children and older adults, Glatt said.

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“Weekly rates of RSV hospitalizations are currently far higher than in the previous four seasons and are exceeding the peak weekly rates in all pediatric age groups since pediatric data began being collected in RSV-NET in October 2018,” a spokesman for the centers for the control said and Disease Prevention (CDC) to Fox News Digital.

RSV-NET reports on the surveillance of recent laboratory-confirmed and RSV-associated hospitalizations in children under 18 years of age and adults.

Blood test indicative of respiratory syncytial virus (RSV). "Rates are now even higher than in fall 2021 when there was an unusual pattern of RSV circulation," said a CDC spokesman.

Blood test indicative of respiratory syncytial virus (RSV). “Rates are higher now than they were in the fall of 2021, when there was an unusual pattern of RSV circulation,” a CDC spokesman said.
(iStock)

“The timing of this is also unusual because we don’t typically see hospitalization rates that high in October and November,” the CDC spokesman also said.

“Rates are now higher than in the fall of 2021 when there was an unusual pattern of RSV circulation.”

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“Certainly, RSV is usually seen in winter, so weather plays a crucial role and in its endemic nature,” added Glatt, also a spokesman for the Infectious Diseases Society of America.

“But if RSV is anywhere around, you can get it in any weather — although it’s really a winter disease,” he said.

Why are we seeing a flood of cases?

“Prior to 2020, seasonal patterns for RSV across the United States were very consistent,” the CDC noted on its website.

“However, the circulation patterns for RSV and other common respiratory viruses have been disrupted since the start of the COVID-19 pandemic in early 2020,” the agency added.

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“CDC is now releasing weekly hospitalization rates for laboratory-confirmed RSV hospitalizations as determined by the RSV-NET Sentinel surveillance system,” a CDC spokesperson told Fox News Digital.

"Circulation patterns for RSV and other common respiratory viruses have been disrupted since the COVID-19 pandemic began in early 2020."

“Circulation patterns for RSV and other common respiratory viruses have been disrupted since the start of the COVID-19 pandemic in early 2020.”
(iStock)

“RSV hospitalization rates are highest in children [who are less than] six months old, but hospitalization rates for older children have also increased compared to previous seasons.”

Many people focus on those who are at high risk of RSV, such as premature babies, young children with heart defects at birth and chronic lung disease — or those who have compromised immune systems.

“Approximately two-thirds of children admitted with RSV are actually healthy, normal children.”

But these patients account for only a third of hospital admissions, said Dr. James H. Conway, pediatric infectious disease physician and medical director of the immunization program at UW Health Kids in Madison, Wisconsin.

“About two-thirds of the children who are admitted with RSV are actually healthy, normal children,” said Conway, who is also a professor of pediatrics in the University of Wisconsin School of Medicine and Public Health.

This transmission electron micrograph shows the morphological features of respiratory syncytial virus (RSV), 1981.

This transmission electron micrograph shows the morphological features of respiratory syncytial virus (RSV), 1981.
(Smith/Gado/Getty Images Collection)

Adult RSV hospitalization rates have also increased, “with the highest hospitalization rates occurring in adults over the age of 65,” a CDC spokesman said.

The data should be interpreted with caution, however, as RSV-NET data for the last two weeks tend to have reporting delays.

Why do some people get infected more than once?

“We’ve known for decades that for most respiratory viruses – whether rhinoviruses, parainfluenza viruses or RSV – immunity to naturally occurring respiratory viruses simply isn’t great,” Conway noted.

“That’s why people can get these infections over and over again.”

And like the flu, people can get infected with different strains of RSV.

According to experts, children can actually get more than one case of RSV.  Similar to influenza, there are several strains of RSV.

According to experts, children can actually get more than one case of RSV. Similar to influenza, there are several strains of RSV.
(iStock)

“Similar to influenza, there are multiple strains of RSV, so there is an RSV-A [strain] and there is an RSV-B [strain] – like there is a flu [type] A duck flu [type] B,” Conway told Fox News Digital.

“People can get it multiple times because even if they have one type, the cross-protective immunity is only partial.”

It is often difficult to prevent infection once the virus has entered the body.

Our immunity has multiple components, including different types of antibodies — circulating antibodies that scour our bloodstream for foreign invaders and secretory antibodies, Conway said.

“There are parts of your immune system that are basically responsible for grasping [the virus and] say “this is important” [to] Present to your immune system’ and ‘This is something we really need to address.'”

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However, it is often difficult to prevent infection once the virus has already entered the body, he added.

The next time the person is exposed to the virus, the immune system remembers it and “assembles” its arsenal of T cells to neutralize the virus.

The first RSV vaccines for older adults in the US could soon be possible.

The first RSV vaccines for older adults in the US could soon be possible.
(iStock)

“But as a temporary measure [the immune system] takes your B cells and turns on a bunch of antibodies that circulate and grab those viruses to pull them out of that circulation [perhaps] before they cause disease,” noted Conway.

Vaccinations for older adults possible

Conway noted that next fall we may have our first RSV vaccines for older adults in the United States

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Several companies, including Pfizer, GSK and Janssen, have RSV vaccines in the final stages of human trials for adults, namely seniors, according to multiple reports.

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“Baby protection in the form of monoclonal antibody injections is already available for high-risk preterm babies, and long-acting versions for all children are also on the horizon,” Conway added.

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