7 Surprising Triggers of Anaphylaxis
The Highly Contagious Virus Potentially Linked Childhood Asthma Cases
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Australia has one of the highest rates of asthma in the world, with about 11 per cent of the population, or 2.8 million people, living with the chronic health condition.
About 80 per cent of children become infected with RSV before their second birthday, and it is the leading cause of lower respiratory tract infections, including bronchiolitis, an asthma-like chest infection.
In rare cases, children require hospitalisation.
Parker Irvine, 5, has been hospitalised with RSV three times and now suffers from asthma. He was first hospitalised with bronchiolitis caused by the virus when he was six weeks old.
Cat Irvine and her son Parker during his first hospitalisation for RSV when he was six weeks old.
His mother, Cat, took him to the emergency department after noticing he was struggling to breathe. The skin between his ribs and under his neck was pulling in with each breath – a sign that he needed urgent medical attention. The newborn was put on oxygen and feeding support in hospital.
"It is disappointing," Cat said. "He could have been a well, healthy child, but because he has had RSV so many times, which has led to bronchiolitis, he now has asthma."
Parker's asthma flares up in cold weather and when he has a respiratory virus. He carries a puffer with him at all times, which he uses when he starts wheezing or coughing.
Parker Irvine, aged 2½ during his fourth admission to hospital for RSV.
Cat is a student midwife and has helped administer free RSV vaccines to newborns at her Perth maternity hospital. While the Western Australian and Queensland governments are funding the vaccine for all newborns, the NSW government is funding the jab for at-risk babies such as those born prematurely. There is no funded RSV vaccination program for children in Victoria.
"I am so pleased that it is available now, " Cat said. "I think about what a difference it could have made to Parker."
While numerous studies have established a strong correlation between falling ill with RSV at a young age and a child developing asthma, causation has yet to be proved.
It is hoped the rollout of free RSV vaccines in Western Australia and Queensland will provide researchers with the data to determine whether avoiding a serious RSV infection in infancy reduces the risk of developing asthma.
Associate Professor Rhys Allan, of the Walter and Eliza Hall Institute of Medical Research, said asthma was a complex disease that was caused by genetic and environmental factors.
These environmental factors might include viruses that cause lower respiratory tract infections and exposure to environmental allergens such as pollens, he said.
"If you get severe RSV in the early years of your life, and it leads to bronchiolitis, then that's often linked to subsequent asthma when you get older," he said.
"They can only still conclude that there's just a really high correlation ... Ultimately vaccination is going to be the key to understanding that."
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Who Should Get An RSV Vaccine? The Guidelines Are Changing
The U.S. Centers for Disease Control and Prevention (CDC) has revised its criteria for who should get vaccinated against RSV (respiratory syncytial virus), a common virus that is generally harmless but that can cause serious and even life-threatening complications in the vulnerable.
On June 26, the federal health agency announced that for the upcoming fall virus virus, it strongly urges vaccination for people in two specific groups — those age 75 and older and those 60 to 74 who are at high risk of severe illness because of chronic health conditions.[1]
That is a change from earlier guidelines, issued last fall, when the CDC advised that people age 60 and older have the option to receive the RSV vaccine, based on discussions with their healthcare provider.[2]
In the June 26 announcement, the CDC director Mandy Cohen, MD, MPH stressed how important it is for adults living in nursing homes to get the RSV vaccine, as they are very susceptible to severe sickness.
The health agency also noted that people who have already received an RSV shot do not need another. The RSV vaccine is not an annual vaccine, meaning people don't need it every virus season.
Why Did the CDC Revise Its Guidelines?"It appears the CDC updated the recommendation to ensure those at highest risk for developing severe illness from RSV are being prioritized for vaccination," says Krutika Kuppalli, MD, spokesperson for the Infectious Diseases Society of America and former medical officer at the World Health Organization.
The U.S. Food and Drug Administration (FDA) approved the first RSV vaccines more than a year ago, but only about 24 percent of adults 60 and over were vaccinated by spring 2024, according to the most recent CDC data.[3]
Dr. Kuppalli anticipates that the more targeted criteria may help get protection to those who will benefit most.
"The initial recommendation was not clear about who should get the vaccine, so this may affect uptake," says Kuppalli.
On the other hand, industry watchers note that the guideline change may reduce immunization rates overall by decreasing the number of eligible people.[4]
RSV Vaccines Can Prevent Hospitalization and Death RSV is a highly contagious virus that can cause symptoms in adults that usually are mild and cold-like symptoms, such as a runny nose, sore throat, cough and headache. But some people who don't have strong defenses can feel absolutely miserable and potentially develop complications such as rapid breathing, fever, and pneumonia.[5]
The federal government estimates that RSV leads to 60,000 to 160,000 hospitalizations annually among adults age 65 and up, and about 6,000 to 10,000 die each year from RSV-related lower respiratory tract disease.[6]
The RSV vaccine may especially help older adults with chronic health conditions avoid some of the more dire outcomes. These illnesses include lung diseases such as chronic obstructive pulmonary disease (COPD) and asthma, and cardiovascular disease such as congestive heart failure and coronary artery disease.[7]
What Are the Different RSV Vaccines?Currently, there are three RSV vaccine options: Arexvy (from GSK), Abrysvo (from Pfizer), and mRESVIA (from Moderna). All are considered effective, although protection drops off over time.
The CDC notes that in a large late-stage clinical trial of Arexvy in people 60 years and older, a single dose of the vaccine reduced symptomatic RSV lower respiratory tract disease by over 82 percent during the first RSV season after vaccination compared to placebo, and by 56 percent during the second RSV season.[8]
In a similar trial with Abrysvo, the CDC says, vaccination reduced RSV lower respiratory tract disease with three or more lower respiratory signs and symptoms by nearly 89 percent during the first RSV season after vaccination compared to placebo and dropped to about 79 percent during a partial second RSV season.[8]
Moderna's mRESVIA, a new RSV shot that was just approved by the FDA in May, had an efficacy against RSV lower respiratory tract disease of between 82 and 84 percent in the first season.[9] In data presented on June 26, however, efficacy of the Moderna vaccine sunk to 50 percent after 18 months.
[10]
Currently the CDC is evaluating the risk of Guillain-Barré syndrome (GBS) in older adults following RSV vaccination. GBS is a rare nerve disorder that can occur after immunization; most people are able to make a full recovery.[11]
What's Going Around: Colds, Seasonal Allergies, Asthma Flare-ups, Bug Bites, Severe Sunburns, COVID, Pink Eye
Here's our weekly round-up of what illnesses are spreading the most in Metro Detroit communities, according to our local doctors and hospitals.
Wayne County – Colds, seasonal allergies, asthma flare-ups, bug bites, severe sunburns, head and arm injuriesDr. Zafar Shamoon -- Emergency chief, Corewell Health Dearborn Hospital
"We haven't been seeing a lot of people come in for anything viral. Instead, we've seen a lot of kids with arm injuries and also head injuries after riding bikes with no helmets. Please, have your kids wear a properly fitted helmet and protective gear to stay safe while riding a bicycle. We've also treated some severe sunburns, so don't forget to use sun protection especially when you're outside for an extended period. And please, be safe if you're using or around fireworks for the Fourth holiday."
Dr. Tiffney Widner -- Pediatrician, Children's Hospital of Michigan
"We're seeing a mix of things: lots of runny noses and congestion for kids with cold symptoms or allergies. We're also seeing patients experiencing asthma attacks. And now with folks getting outside more, we're seeing patients with bug bites."
Dr. Roy Elrod -- Chief of Emergency Medicine, DMC Detroit Receiving Hospital
"Seeing increase in injuries especially outside activity related injuries -both recreational and work related."
Dr. Dan Taylor -- Chief of Emergency Medicine, DMC Sinai-Grace Hospital
"There has been an Increase in trauma related injuries as summer weather ensues."
Oakland County – Sports injuries, heat-related issues, upper respiratory infections, COVID, pink eye, strep throatDr. David Donaldson -- Emergency Chief, Corewell Health Beaumont Troy Hospital
"There hasn't been a lot of infectious diseases going around right now. We are seeing a lot of sports injuries and heat-related issues come into our emergency department. We've also seen several motorcycle accidents."
Dr. Rena Daiza -- Primary Care Physician, Henry Ford Medical Center Bloomfield Twp.
"This week we continue to have increased cases of upper respiratory infections including COVID-19. These infections can increase asthma and allergy related symptoms and cause pneumonia in more severe cases. It is important to stay up to date with recommended vaccinations and remain home when sick."
Emergency Department, Henry Ford West Bloomfield Hospital
"We're seeing a lot of falls this week along with chest pain, abdominal pain, and diarrhea."
Emergency Department, Trinity Health Oakland
"We continue to see many trauma incidents related to outdoor activities, and multi-vehicle accidents."
Washtenaw County – Outdoor injuries, heat exhaustion, stomach viruses, COVIDDr. Marisa Louie -- Medical Director of Children's Emergency Services, Michigan Medicine
"Lots of kids with recreation-related injuries, like fractures, imbedded fishhooks, lacerations. We had another patient with heat exhaustion. Still a fair number of vomiting/diarrheal illnesses."
Dr. Brad Uren -- Clinical Associate Professor of Emergency Medicine, Michigan Medicine
"Seeing a few more cases of COVID this week than previous. Minimal GI illnesses."
Emergency Department, Chelsea Hospital
"In Chelsea, we are seeing an increase in trauma related issues."
Monroe County – Did not report this week Macomb County – Outdoor injuries, seasonal allergies, asthma flare-ups, skin rashes, hives, strep throat, COVIDDr. William Halacoglu -- Emergency physician at McLaren Macomb
"Various natural irritants, including allergens, have been causing complications, such as asthma exacerbation and various forms of skin rashes and hives. Minor orthopedic fractures and breaks and various soft tissue injuries mainly sustained during outdoor activities continue to be treated in high volumes. With reports of increasing COVID-19 cases across the country, there has been no similar trend of cases being diagnosed in the emergency department."
Dr. Maria Samuel -- Primary Care Physician, Henry Ford Medical Center Sterling Heights
"I'm seeing rashes from working outdoors and a few strep and COVID-19 cases going around."
Livingston County -- Outdoor injuries, seasonal allergies, asthma flare-ups, bug bitesEmergency Department, Trinity Health Livingston
"We are seeing an increase in trauma injuries related to yard work, ATV use, etc. Also, a reminder to the community to please keep safety in the forefront for the holiday, including for any fire work usage, bon fires, and travel."
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