Is it flu or this other serious virus?
You or your child get a fever and then sinus congestion and a really bad cough. You fear that influenza has entered your home. But those symptoms are also indicative of another lesser discussed, but no less serious, virus called Respiratory Syncytial Virus, or RSV.
“RSV presents very similarly to a lot of viral pathogens with fever, often sinus congestion progressing to a cough,” said Cape Cod Hospital Infectious Disease Specialist Patrick Cahill, MD. “You will generally see the worsening cough with either the flu or RSV and it’s really hard to identify which pathogen it is just by looking at the patient. Most of the time it does help that we have the better availability of the viral detection techniques in the hospital lab.”
The similarities between the two viruses go beyond just symptoms. They are both highly contagious from person-to-person contact. They can also live on hard surfaces and inanimate objects and can be transmitted to people that way.
To avoid catching either virus, according to Dr. Cahill, you should practice good hand hygiene and be sure to wash hands with soap and water at least 20 seconds, or use antibacterial gel, if a sink is unavailable. Always wash your hands before eating or touching your face. Also wiping down shopping carts with the antibacterial wipes provided by stores is a good idea.
People who have either the flu or RSV should stay home to avoid spreading the virus to others. If you have to seek medical care because of worsening conditions or trouble breathing, please inform the clinic or hospital about your symptoms right away so they can give you a mask to prevent spreading germs.
Even though the two viruses present in similar ways, they are very different in both the way they progress and how they are treated.
Influenza Or ‘Flu’
Every flu season is unpredictable and this one is no different. Typically, the flu begins later and influenza A is the most predominant strain. This year, the flu season got off to an early start and influenza B is currently the most common strain, according to the Centers for Disease Control and Prevention in their Morbidity and Mortality Weekly Report posted January 10.
The CDC reports that influenza B viruses have not predominated in the U.S. in 27 years, but this year influenza B viruses account for 60 percent of the circulating flu. In comparison, for the last three years influenza B accounted for less than 10 percent of circulating viruses and usually occurred later in the spring.
“Often it just comes down to what has been circulating elsewhere and what was initially introduced into the U.S., because these are circulating around the world year-round really,” Dr. Cahill said. “Influenza A and influenza B would basically be indistinguishable on clinical presentation. The symptoms of both are typically fevers, chills, body aches and sinus congestion which may progress to lower respiratory infections like a cough, shortness of breath and then pneumonia. What we worry about is people developing bacterial pneumonia on top of viral pneumonia which is how people get really sick.”
The biggest difference between the two flu strains is that Influenza B typically targets small children and hits that population harder. Influenza A is more dangerous for older adults or those with compromised immune systems.
No matter which strain of the flu you have, it typically lasts for five to seven days, Dr. Cahill said. Taking an antiviral medication like Tamiflu has been shown to decrease symptoms by a half a day or more. A new single dose medication called baloxavir is showing some promise, sometimes when combined with Tamiflu for especially severe cases. And Tamiflu is a good precaution for those who have come into close contact with the flu.
“If somebody has been in close contact with someone with the flu, it’s not a bad idea to take the prophylactic dose, which is the same medication, Tamiflu, but it is taken once a day instead of twice a day,” Dr. Cahill said. “I’m sure most of the primary care doctors would be happy to do that to reduce the likelihood of someone becoming very sick from the flu.”
But the biggest thing that you can do is get the flu shot and it is not too late to get one this season.
“Even if reports are saying that it is not a good year for the flu shot as far as the predicted efficacy, it still is often associated with less severe presentations of the flu, if you do come in contact with it,” Dr. Cahill said. “If people have not already gotten it, I would still strongly recommend getting a flu shot.”
Respiratory Syncytial Virus
“RSV is one of the more common respiratory viruses and it’s one of the more severe ones,” Dr. Cahill said. “Especially in kids, it can be really bad but it can also be serious in some adults. Anybody with a co-morbidity from respiratory conditions like asthma and COPD and even some heart diseases like congestive heart failure can have more severe presentation of the virus.”
The other issue with RSV is that it can promote an almost asthma-like response in the body by triggering different inflammatory pathways and antibodies that have been linked in children who get it to the development of asthma later in life, Dr. Cahill said.
There are currently no real treatments for RSV beyond relieving symptoms with over the counter medications such as fever reducers or pain medication. Be sure to ask your pediatrician about using any cold medicines in children because some of them are not appropriate for young kids. It’s also important to stay hydrated.
For most people, RSV should go away on its own in one or two weeks. Anyone who has difficulty breathing should seek immediate medical care because those symptoms could indicate bronchiolitis or pneumonia.
“It’s a serious year for RSV,” Dr. Cahill said. “It’s also been a serious year for the flu, just because it started earlier. I think we see a lot of these viral conditions around here because generally speaking we have an older population. They’re often dealing with more co-morbidities and are less likely to shrug off milder presentations of these things.”
Infographic Credit: https://www.cdc.gov/