Flu Not The Only Germ Threat This Time Of Year

[Guest guest]

Source: University of Rochester Medical Center

Date: 2006-01-13

URL: http://www.sciencedaily.com/releases/2006/01/060113111415.htm

Flu Not The Only Germ Threat This Time Of Year: RSV, Other Stealth

Bugs Often The Culprit For What's Bugging You

The flu hasn't even hit hard yet this year, but it seems like

everyone's getting sick. What's the deal?

Simply put, there are a lot more infectious invaders besides the flu

to worry about. They don't get the big headlines, but they still

knock people down for days or weeks and cause thousands of deaths

each winter.

Metapneumovirus. Rhinoviruses. Coronaviruses. Parainfluenza.

Respiratory syncytial virus (RSV). Pronouncing the names of the

microbes can be almost as difficult as bearing the illnesses

themselves. They're on doorknobs, faucets, and appliance handles all

around you, and maybe in your nose and lungs too. Some of the

viruses are also wafting through the air you breathe, looking to

land in your eyes or nose and set up house inside your body. And

those are just the respiratory germs -- never mind Strep in the

throat and ears, or Norwalk viral agents that attack the GI system,

and so on.

While the world's attention has migrated to bird flu, not a single

person in the western hemisphere has contracted the deadly form of

the disease. And though " regular " flu is still a potent threat,

expected to kill more than 35,000 people in the United States

annually, your sick neighbor or colleague who probably doesn't have

the flu is a sniffling, sneezing, wheezing, whining reminder that

there are other germ threats.

Infectious disease experts at the University of Rochester Medical

Center have tracked the dangers from one of the most common bugs,

RSV, and they say the threat to some groups of people, such as the

elderly, equals that from flu. Even though flu gets all the press,

RSV is a stealth bug worthy of attention too.

Ann Falsey, M.D., and Walsh, M.D., faculty members in the

University's Infectious Disease Unit of the Department of Medicine,

have found that RSV affects elderly and high-risk adults as much as

the flu. In a paper published last year in the New England Journal

of Medicine, they estimated that 14,000 elderly and high-risk adults

die annually from an RSV infection, and that the bug is responsible

for more than 177,500 hospitalizations of adults each year. In

addition, pediatricians have long known that the bug is a danger to

small children, affecting hundreds of thousands of children annually

as the biggest cause of bronchiolitis and pneumonia among infants

and children under 1 year of age.

For more than a decade Falsey and Walsh, who are infectious disease

experts at Rochester General Hospital, have been on the hunt for a

vaccine against RSV. While they've identified several proteins on

the surface of RSV, an important step toward creating a vaccine,

none of the vaccines they've tested has panned out.

So while people tense up about the availability of flu vaccine or

wait in long lines for a flu shot, that opportunity for prevention

doesn't even present itself for RSV. Falsey and Walsh have shown

that over a four-year span in Rochester, about the same number of

people visited the doctor and were hospitalized for RSV and flu, and

that RSV infection caused more than 10 percent of hospitalizations

for pneumonia during the winter.

" At least with the flu, we have something to control it -- a

vaccine, " Falsey said. " We don't even have that for RSV. The lack of

awareness is a big problem. It costs a great deal of money to

develop a vaccine, but there's not much of a demand for a vaccine

against an illness that a lot of people haven't even heard of.

" A lot of cases that people think are from flu aren't really the flu

at all, but other respiratory viruses like RSV. RSV is responsible

for a lot of the illness blamed on flu, " said Falsey, whose work is

funded by the National Institute of Allergy and Infectious Diseases.

It's tough to tell RSV apart from the flu. Both are primarily

respiratory illnesses whose effects can range from simply giving the

person a few sniffles to causing life-threatening pneumonia. Someone

with the flu is more likely to have a fever and body aches, and

someone with RSV is more likely to have a runny nose, a cough that

produces mucus, and wheezing.

Flu is more likely to spread as an aerosol -- someone coughs and the

airborne virus lands on another person, or they cough and then touch

the faucet or doorknob. RSV, like the common cold, spreads mainly as

large droplets via surfaces -- doorknobs, faucets, dishtowels, and

hand-to-hand contact, for instance.

" Unlike the flu, RSV is more often spread directly by secretions, "

said Hall, M.D., a geriatrician and pulmonary specialist at

the University of Rochester Medical Center who has studied how

respiratory viruses are spread in communities like nursing

homes. " RSV lives on objects including faucets, door handles, and

change from the coffee shop, for quite awhile, for at least a day.

If you put your finger in your mouth, or touch your eye, or pick

your nose, you're a spreader, to put it bluntly. People share cell

phones, they shake hands to be social. These are effective ways to

transmit disease. "

While RSV may sound new, the best way to prevent it -- washing your

hands -- is not.

" We've known for more than 100 years that hand washing prevents

infection, but we still can't get people to wash their hands, " said

Falsey. " Hand washing is the simplest, most effective way to keep

from getting sick and making others sick. But it's hard to get

people to wash their hands. "

In the early 1990s Falsey led an experiment involving hand washing

among staff members at an adult day care center. She found that

respiratory infections were less frequent among residents cared for

by workers equipped with packs containing germ-killing hand gels who

used the gels regularly. The team also found that RSV was spread to

residents mainly through health care workers who had young children

at home.

While investigators like Falsey and Walsh search for a vaccine

against RSV, and a better way to check people who may have the

illness, for ordinary people the effects and treatment are largely

the same, whether a person gets the flu, RSV, the common cold, or

another respiratory ailment. Feel crummy. Rest, drink lots of

fluids, and if you suspect the flu, call a doctor immediately,

because flu can be treated effectively with new medications as long

as it's caught within the first 48 hours.