RSV spike raises questions about repeat cases: Could you or your child get it again?

As respiratory syncytial virus, also known as RSV, continues to increase in the United States, experts warn that it’s possible people could become 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 a 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 RSV hospital admissions are currently much higher than in the previous four seasons, exceeding peak weekly rates in all pediatric age groups since RSV-NET pediatric data collection began in October 2018,” said a spokesperson for the Centers. for Disease Control and Prevention (CDC) told Fox News Digital.

RSV-NET reports surveillance for recent lab-confirmed and RSV-associated hospitalizations in children less than 18 years of age, plus adults.

Blood sample suggestive of respiratory syncytial virus (RSV). "Rates are now higher than they were, even compared to Fall 2021, when there was an unusual pattern of RSV circulation," said a CDC spokesman.

Blood sample suggestive of respiratory syncytial virus (RSV). “Rates are now higher than they even were compared to fall 2021, when there was an unusual pattern of RSV circulation,” said a CDC spokesperson.
(iStock)

“The timing of this is also unusual, as we don’t normally see hospitalization rates this high in October and November,” the CDC spokesperson also said.

“Rates are now higher than they even were compared to fall 2021, when there was an unusual pattern of RSV circulation.”

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“Certainly RSV is normally seen in winter, so weather plays a critical role in its endemicity,” added Glatt, also a spokesperson for the Infectious Diseases Society of America.

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

Why are we seeing a wave of cases?

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

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

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“CDC is now publishing weekly hospitalization rates for lab-confirmed RSV hospitalizations, as determined through 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 onset of the COVID-19 pandemic in early 2020."

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

“RSV hospital admissions are highest in children [who are less than] six months old, but the number of hospitalizations has also increased in older children compared to previous seasons.”

Many people target those who are at high risk for RSV, such as premature babies, young children with heart defects at birth and chronic lung disease — or those with weakened immune systems.

“About two-thirds of children who are hospitalized with RSV are actually healthy, normal children.”

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

“About two-thirds of the kids who are hospitalized with RSV are actually healthy, normal kids,” says Conway, who is also a professor of pediatrics at the University of Wisconsin School of Medicine and Public Health.

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

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

Hospitalization rates in adults with RSV have also increased, “with the highest hospitalizations in adults age 65 and older,” according to a CDC spokesperson.

However, the data should be interpreted with caution as the most recent two weeks of RSV-NET data is prone to a delay in reporting.

Why are some people infected more than once?

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

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

And just like with the flu, people can become infected with different types of RSV.

Indeed, children can get more than one case of RSV, experts said.  As with the flu, there are multiple RSV strains.

Indeed, children can get more than one case of RSV, experts said. As with the flu, there are multiple RSV strains.
(iStock)

“As with the flu, there are multiple strains of RSV, so there is an RSV-A [strain] and there is an RSV-B [strain] – just like there’s the flu [type] A and 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 already entered the body.

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

“There are parts of your immune system that are responsible for seizing [the virus and] say, “This is important” [to] present to your immune system,” and “This is something we really need to deal with.”

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However, it is often difficult to prevent an 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 lines up its arsenal of T cells to neutralize the virus.

The first RSV vaccines for older adults in the US may be available soon.

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

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

Vaccines possible for older adults

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

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Multiple companies, including Pfizer, GSK and Janssen, have RSV vaccines in late-stage human trials for adults, namely seniors, according to multiple reports.

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

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