Māori and Pasifika at risk of hospitalisation from ‘extremely contagious’ severe respiratory infection

The number of people in hospital from severe respiratory illness, including influenza, last year peaked at levels higher than at any time in almost a decade.. Photo / NZ Herald

Health experts are warning New Zealanders to be vigilant this winter with new data showing hospital admissions in Auckland for acute respiratory diseases are up 13 per cent on the same time last year.

Data from the Institute of Environmental Science and Research (ESR) shows the number of hospitalisations from severe respiratory illness, including acute conditions such as Covid-19, influenza, and RSV, last year peaked at levels higher than at any time in almost a decade.

The figures also show the number of acute respiratory admissions since the start of this year exceeds the previous year.

Respiratory diseases such as influenza, Covid-19 and respiratory syncytial virus (RSV) are seasonal with case numbers expected to spike during the winter months.

Dr Lutz Beckert, professor of medicine at the University of Otago and a respiratory specialist with Te Whatu Ora Canterbury. Photo / NZ Herald

RSV is a highly contagious respiratory virus that can affect people of any age, but older adults are at greater risk.

Māori and Pasifika and those living in lower socioeconomic areas also have a greater risk of hospitalisation from the disease.

RSV is associated with severe respiratory disease in people aged over 60, and so far this year, along with rhinovirus it is the most common respiratory virus among those tested in hospital. Covid-19 and influenza are now the third and fourth most common respiratory viruses detected, respectively.

Dr Lutz Beckert, professor of medicine at the University of Otago and a respiratory specialist with Te Whatu Ora Canterbury, says RSV is under-recognised and can be a serious illness in adults, particularly those with existing respiratory disease.

“RSV is an airborne virus and spreads much the same way as influenza and Covid-19, through respiratory droplets via direct contact with an infected individual or, with contaminated surfaces - where it can live for up to six hours.

“We must not forget our Covid-19 lessons. During the pandemic we were able to maintain hygiene standards, wore masks and practised social distancing when we were sick.”

Beckert says experts are concerned that a combination of respiratory diseases particularly influenza combined with RSV could see an influx of hospital admissions over the coming winter months.

“Māori and Pacific peoples are more likely to be exposed to risk factors that increase the likelihood of harm from RSV. These risk factors include overcrowding and housing instability, lower-paid employment opportunities and less access to timely medical treatment.

“Although healthy adults with RSV may have symptoms similar to the common cold and mostly be able to recover at home, older adults, especially those with compromised immune systems or heart or lung conditions, can be at higher risk from RSV. They may be more likely to suffer from severe consequences, such as pneumonia or even hospitalisation. Babies and very young children are also at higher risk and can become very unwell quickly.

“The initial symptoms are not dissimilar to a common cold so it is important that patients monitor their symptoms and seek immediate medical assistance if they find themselves short of breath, wheezing, feverish or their cough worsens.

RSV is a notifiable disease in Australia and Beckert says it would be of benefit to have it added to New Zealand public health data to improve national surveillance.

Beckert says RSV infections typically follow a seasonal pattern, generally peaking during winter.

“We need to treat RSV as seriously as we treat Covid or influenza.”

Professor Graham Le Gros, immunologist and director of the Malaghan Institute of Medical Research. Photo / NZ Herald

Professor Graham Le Gros, immunologist and director of the Malaghan Institute of Medical Research, says older adults and those with existing medical conditions need to be vigilant in protecting themselves against RSV as the weather cools.

“We know that those in this cohort who have chronic medical conditions such diabetes, asthma, chronic obstructive pulmonary disease [COPD] and heart failure do have an elevated risk of hospitalisation from RSV.”

Le Gros says while the disease is often associated with young children, older adults are also particularly vulnerable.

“Scientists have been working for decades on ways to prevent RSV infection through immunisation. We know that without vaccination our population is vulnerable to infectious diseases like RSV as was seen in the 2021 outbreak with multiple elderly patients and children hospitalised.

“RSV reduces your ability to breathe and affects the chest and lungs with symptoms which are very similar to pneumonia in children and the elderly.”

Le Gros says any natural immunity built up from a prior infection is minimal so older patients do need protection against the disease.

“RSV is an extremely contagious disease and in environments like aged care facilities, there is a risk of the virus infecting multiple residents at any one time which can put enormous pressure on the health care system.”

A vaccine against RSV is now available from New Zealand GP clinics for private purchase.

Arexvy is the world’s first respiratory syncytial virus (RSV) vaccine for older adults and has been registered in Canada, Australia, US, UK, the European Union, Japan and New Zealand. Research shows almost a quarter of US adults aged 60+ have reported receiving an RSV vaccine.

Trial data shows Arexvy has an overall efficacy of 82.6 per cent against RSV-Lower Respiratory Tract Disease (LRTD) however as with other vaccines, the vaccine may not protect all recipients.

- NZ Herald