Bactrim DS Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
RSV In Older Adults
When most people think of respiratory syncytial virus (RSV), they usually think of babies. But you can get it at any age. And if you're older than 60, you're at even greater risk for RSV. "The virus is increasingly recognized as a significant cause of respiratory illness in older adults in the U.S.," says William Schaffner, MD, a spokesperson and former medical director for the National Foundation for Infectious Diseases. The CDC estimates that 177,000 older adults are hospitalized every year and 14,000 die from RSV infections.
What should older adults know about RSV? It is a highly contagious respiratory virus. That means it spreads very easily. RSV infects your nose, throat, lungs, and breathing passages. You'll have symptoms like those of a common cold.
RSV can be easily dismissed as a cold in people who are healthy. It's also easy to confuse RSV with other viruses, like the flu and COVID-19. Loved ones and caregivers should be aware of the chance that RSV in older adults can cause serious sickness or may even be fatal.
Are RSV Symptoms in Older Adults Different?Symptoms of RSV may look different, depending on how old you are. Young infants may be cranky, not as active, and have a hard time breathing. In adults, symptoms can include:
Serious infections in adults may cause pneumonia (an infection in one or both lungs) or bronchiolitis (an inflammation of the respiratory tract). You can watch for signs that RSV may be getting worse, such as:
If you're having trouble breathing or your skin turns bluish, call 911 right away.
Diagnosing RSV in AdultsSince RSV often seems like a cold or the flu, your doctor will try to figure out exactly what you have. First, they'll ask questions about your medical history. They'll pay special attention to the symptoms you tell them about. Next, your doctor will give you a physical exam. If they suspect RSV, they'll likely do some follow-up lab tests, which may include:
Rapid RSV antigen test: This is the quickest way to diagnose RSV. A fluid sample is taken from your nose (with a nasal swab or gentle suction) to check for certain proteins called antigens. You can usually get results in about an hour.
Molecular test: Sometimes, only small amounts of the virus are in your nose. For older adults, an RT-PCR test (which also uses a nasal swab) can find a smaller amount, compared to an antigen test. The samples are usually sent to a lab. In certain cases, your doctor might run a respiratory panel test to look for RSV as well as other viruses and bacteria.
You don't have to do anything to prepare for these tests. But you may feel some discomfort from the nasal swab. The best time to do these tests is within the first days of symptoms.
How Do Adults Spread RSV?RSV often spreads quickly. Children can spread RSV and other germs in day care. But adults pass on RSV in any situation similar to how they might spread a cold. Here are some common ways it can happen:
If you have RSV, you can be contagious for at least 3-8 days. But if you have a weakened immune system, you can spread the disease for as long as 4 weeks, even if you don't have symptoms anymore. RSV infections most often happen in the fall, winter, and spring (November to April). But you can get it in any season.
How Does RSV Affect Adults Older Than 60?For most adults, RSV will cause cold-like symptoms and will get better within 1 or 2 weeks.
But some adults may have more serious complications, like:
RSV symptoms can be much more serious in older adults who have asthma, COPD, and weakened immune systems. And almost everyone's immune system gets weaker as we age, which puts older adults at greater risk.
Sometimes, RSV is fatal.
What Treatments Are Available for Adults with RSV?There are vaccines to protect older adults from severe cases of RSV.
Your doctor may suggest over-the-counter pain relievers or fever reducers. And saline drops or sprays can help with stuffy noses. While symptoms will go away for most adults, older adults with complications may have to go to the hospital. Generally, treatments involve supportive care, like:
Early treatment with aerosol ribavirin that you inhale and immunoglobulin in your vein may improve survival if you have a very weak immune system.
How Can RSV in Older People Be Prevented?If you're at high risk for RSV – or you're a caregiver or loved one of an adult over 60 who may be more prone to getting it – there are things you can do to keep yourself and them healthy:
Get vaccinated. The FDA has approved two RSV vaccines for adults 60 and older.
Avoid close contact with sick people. This includes touching, kissing, or hugging someone who has cold-like symptoms. Don't drink from the same glass or share eating utensils. If you can't avoid close contact, think about using a mask or gloves.
Wash your hands often. Use soap and water for at least 20 seconds. If washing your hands isn't an option, use an alcohol-based sanitizer to keep germs off fingers and palms.
Avoid putting your hands on your face. Germs can be spread by touching your nose, eyes, and mouth.
Clean and disinfect surfaces. Regularly cleaning counters, doorknobs, mobile devices, or other surfaces you constantly touch is a good practice to help stop illness. RSV can stay on surfaces for several hours. That is true whether someone with RSV coughs or sneezes droplets onto the surfaces or just touches them.
Cover your mouth when you sneeze or cough. If you are around an older loved one a lot, make sure you are covering your mouth and nose when you cough or sneeze. Use a tissue, then throw it away afterward (and wash your hands). If you feel a sneeze coming on and don't have a tissue, sneeze into your upper shirt sleeve.
What Is the Outlook for People Over 60 Who Get RSV?Not all adults with RSV will have to go to the hospital. But some may face serious complications, especially if they already have weakened immune systems or long-term lung and heart problems.
Researchers have found ways to stop and treat RSV. Those include vaccines and monoclonal antibodies targeted for infants and young children, older adults, pregnant people, and people who have weak immune systems.
"There is a need for rapid, inexpensive, highly accurate, and easy-to-use RSV" tests at places where people go for health care. That's especially true for "primary care practices, which can help increase awareness of RSV infection in vulnerable populations," Schaffner says.
Dear Doctor: Is There Any Benefit To Treating People Who Have A Fever Versus Letting It Run Its Course?
DEAR DR. ROACH: Does taking a medicine to reduce fever hurt? I read that fever is useful for the body to fight off infections. -- J.S.
ANSWER: There is some experimental evidence that higher temperatures help the body kill bacteria and control virus infections, but the magnitude of the benefit is probably small. Fever is an ancient and near-universal response to infection across the animal kingdom, suggesting (but not proving) a benefit.
Studies that compare treating people with fever versus letting the fever run its course haven't shown a clear benefit to treatment. However, there isn't a lot of harm in suppressing a fever with medications like acetaminophen. Personally, I don't rush to treat my adult patients who have a fever with medications or cooling unless the patient is very uncomfortable. It's a matter of preference and is unlikely to help or harm a person much.
DEAR DR. ROACH: I am a healthy 61-year-old male. I recently donated my left kidney anonymously in January, so I think I am extremely healthy. Would you happen to know if there are any limitations (age or otherwise) to donating a portion of the liver? -- T.
ANSWER: It is a remarkable to give part of yourself to another person. I've never known anyone to donate both a kidney and part of their liver.
Age is a potential limitation on donating. Different programs may have different age cutoffs, but 60 is a common one. In one large study, there was no difference in complications when comparing donors from age 20 to age 63. Very overweight or obese people generally may not donate due to the risk of fatty liver disease.
The medical evaluation for a liver donor looks for evidence of infection (hepatitis and HIV in particular, but any chronic infection including tuberculosis or syphilis); any active cancer; psychiatric disease; and one genetic condition (alpha-1 antitrypsin). Any kind of coercion (including financial) would prevent a donation.
Finally, the donor must have a large-enough liver volume so that they will have adequate liver function after their donation. Either the left or right lobe of the donor's liver may be used. The liver has the capacity to regenerate itself so that by six months, it is usually 80% to 90% of its original size. (Repeat partial liver donation is never allowed.)
There is the potential for harm from this surgery. A donor is usually out of work for two months or more, requiring assistance from others immediately after surgery. Published rates of mortality from donations range from 1 in 250 to 1 in 2,500. Those numbers may sound low, but they are much higher than a routine operation like a gallbladder surgery. Although 25% of donors had a complication, the vast majority were minor or minimal (such as a blood transfusion).
I admire your altruism, but personally, I think you have more than adequately donated. A partial liver transplant is a more difficult and dangerous surgery than a kidney donation, and it requires careful deliberation.
* * *
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.Cornell.Edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
(c) 2022 North America Syndicate Inc.
All Rights Reserved
If you purchase a product or register for an account through a link on our site, we may receive compensation. By using this site, you consent to our User Agreement and agree that your clicks, interactions, and personal information may be collected, recorded, and/or stored by us and social media and other third-party partners in accordance with our Privacy Policy.
Function Of Fever:
When a child or parent becomes feverish with shivers, chills, and sweats, our first thought is to get the temperature down. Pharmacies sell billions of fever-reducing pills like aspirin and acetaminophen every year, and schools often insist that students stay home until their fever is gone.
But is this "fever phobia" backed up by science?
Increasingly, medical researchers are discovering that fever has endured in mammals and other creatures for good reasons, though the reasons why are not clear. Often, a fever in response to an infection is actually a reflection of the body's defenses going into high gear. Some parts of the immune system work better at a higher temperature, which strengthens resistance to infection and increases the odds of survival.
The new thinking is that mild fever can be a positive adaptation and shouldn't necessarily be treated. At other times, though, fever may spur the microbes' growth rate by raising the temperature of the host body. In this case, the attackers have evolved a way to chemically manipulate the host's immune system for their own advantage. And a high fever is a danger sign, especially in young children.
What is this mysterious phenomenon, fever? It's not simply a rise in body temperature. It is an upward shift in the body's "set point," or core temperature, which is regulated by the hypothalamus in the brain. In response to an infection, the body releases chemicals that cause a sensation of being cold. The hypothalamus then raises the set point by making the body burn fat, reduce blood flow to the skin, and shiver.
Most of the time, fever isn't dangerous in itself, but a patient will feel more comfortable at a lower temperature. In a dramatic demonstration of fever's benefits, researcher Matthew Kluger infected desert iguanas with bacteria.
Because these lizards are cold-blooded, they could only warm their bodies by seeking outside heat -- in this case, sunlamps. All except one of 13 iguanas sought the warmth to raise their temperatures, and those 12 survived; the other one died.
After that, Kluger injected 12 other iguanas with live bacteria, and also gave them a fever-fighting drug. Five of them failed to develop a fever, and died as a result. The other seven, which somehow became feverish despite the drug, survived.
Despite experiments like this, scientists haven't yet answered all their questions about this common and ancient body symptom.
Comments
Post a Comment