How to beat coughs and sneezes: The reason you get every cold going

Dr Joseph Aracri Discusses RSV In Infants

Joseph Aracri, DO, Allegheny Health Network, spoke with The American Journal of Managed Care® about preventing respiratory syncytial virus (RSV) through immunoglobulin-based treatments and everyday actions.

Joseph Aracri, DO, system chair of pediatrics with AHN Pediatric Institute and medical director of the Medical Nutrition Clinic, Allegheny Health Network, spoke with The American Journal of Managed Care® about preventing respiratory syncytial virus (RSV) in infants and young children.

Transcript

How are new vaccines changing treatment of RSV in infants and young children?

The treatment for children, for infants, is not a vaccine, it's an immunoglobulin. So what we're doing is actually giving antibodies to the babies when they're born to help prevent significant RSV disease. That is, RSV disease that will end up in the hospital or frequent visits to the pediatrician's office. We really think that this is going to be a game changer for these kids and hopefully keep them well through their first respiratory season.

What are some other things that parents can do to protect their children from severe infection?

Really, RSV is a very contagious virus that goes around every year. Usually, by the time the kid is 2, they've already had 2 infections. The majority of RSV infections are just runny nose, cough, maybe a low-grade fever. In some kids, fewer than 5%, [they] will have trouble breathing and almost like an asthma-like attack that's associated with it. What can you do to prevent it? It's just basically other things you do to prevent colds. You know, making sure you wash your hands before touching your baby. If somebody is sick, don't have them around your baby. Those kinds of things. But really, the virus is so contagious and all over the place, it's very hard to avoid.

Children's Cough & RUNNY NOSE

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.G. Doctor or pharmacist) for more information.

How the interaction occurs:

Desvenlafaxine may increase the amount of atomoxetine, dextromethorphan, metoprolol, nebivolol, perphenazine, or tolterodine in your blood by slowing down how quickly your liver processes these medicines.

What might happen:

Your blood levels of atomoxetine, dextromethorphan, metoprolol, nebivolol, perphenazine, or tolterodine may increase and could cause toxic effects.

What you should do about this interaction:

Let your healthcare professionals (e.G. Doctor or pharmacist) know that you are taking these medicines together.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Keep all of your appointments with the doctor and laboratory. Do not start, stop, or change the dosage of any medicine before checking with them first.

View Reference

Search Drugs Related Drugs

Select a condition to view a list of medication options

View More

Drug Survey

This survey is being conducted by the WebMD marketing sciences department.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Why The New RSV Treatments Are A Big Deal

25 November 2021, Baden-Wuerttemberg, Stuttgart: An intensive care nurse cares for a patient ... [+] suffering from respiratory syncytial virus (RS virus or RSV) who is being ventilated in the children's intensive care unit of the Olgahospital in Stuttgart. Photo: Marijan Murat/dpa (Photo by Marijan Murat/picture alliance via Getty Images)

dpa/picture alliance via Getty Images

Several important treatments have emerged to help prevent infection from Respiratory Syncytial Virus (RSV) in those that are most susceptible to it; namely young children and adults. Specifically, the FDA recently approved Arexvy, the world's first vaccine to fight RSV in adults aged 60 and older. According to its manufacturer GSK, the single shot provides long-term protection against a common respiratory infection that can be lethal in some patients.

The FDA also approved a monoclonal antibody treatment for infants and children up to 24 months of age who remain vulnerable to RSV. The drug, known as Beyfortus, is an antibody that fights against RSV that is administered as a single injection.

Finally, a vaccine produced by Pfizer to protect babies against RSV from birth could be approved in just weeks by the FDA by immunizing pregnant patients. According to Pfizer, this vaccine would protect newborns and infants up to six months of age against severe disease from RSV.

These groundbreaking therapies will be a gamechanger from a public health perspective in the fight to protect those most vulnerable to RSV infection. Here's why.

RSV is a common upper respiratory infection that infects nearly everyone by the age of two. Most cases are mild and result in fever, cough, runny nose, and possibly wheezing. However, it can cause severe disease resulting in pneumonia or inflammation of the airways, a condition known as bronchiolitis.

Respiratory syncytial virus (RSV), negative-sense enveloped RNA virus, revealed is the ... [+] photomicrograph film using indirect immunofluorescence technique, 1977. Image courtesy Centers for Disease Control (CDC) / Dr H. Craig Lyerla. (Photo by Smith Collection/Gado/Getty Images)

Getty Images

Annually, RSV results in 60,000 to 120,000 hospitalizations in America for adults aged 65 and older, and 6,000 to 10,000 deaths. For children under the age of five, the virus accounts for about 58,000 hospitalizations a year in the US and up to 500 deaths. The new vaccine for adults and antibody for children will invariably curb these numbers, ultimately saving the lives of thousands of Americans.

Furthermore, these therapies will keep more people out of the hospital and decrease the number of patients experiencing severe disease. Patients hospitalized for RSV require supportive therapy which can include IV fluids, oxygen, and mechanical ventilation to help breathe. Seeing loved ones on a ventilator can be traumatizing emotionally, and these promising treatments will certainly decrease the number of infants and elderly that will need to be placed on a ventilator.

Additionally, RSV is extremely contagious, nearly twice as contagious as Influenza according to research in Journal of Theoretical Biology. This means that the virus is easier to spread amongst people than the common flu. This is also why the CDC has recommended covering sneezes and coughs with a tissue paper rather than one's hands as a means to limit the spread of RSV. With newer therapies aimed at curbing RSV infection, the sheer number of infections will likely decrease, thus limiting the spread of this contagious virus.

Finally, the success of these new treatments could help restore public trust in science and novel treatments like vaccines. As seen with the Covid vaccines, suboptimal vaccine uptake rates were associated with medical mistrust, according to research in the journal SSM- Population Health. Vaccine hesitancy has become an increasing problem in the United States with the resurgence of some diseases like Measles that were previously thought to be eradicated because less patients and parents are choosing to vaccinate their children. If RSV infections, deaths and hospitalizations can be mitigated by the new RSV therapies, then perhaps some Americans will begin to develop trust in science and the potential for vaccine efficacy.

The novel RSV therapies could be a major triumph for science and public health. Only time will tell if this is a reality.

---