RSV Surge in Hong Kong: Highlighting the Crucial Role of Disinfection and Hygiene

The recent cancellation of renowned singer Jackie Cheung's concert due to Respiratory Syncytial Virus (RSV) infection has brought significant attention to this potentially deadly virus. In fact, Professor Ivan Hung, a leading infectious disease expert and the Head of the Division of Infectious Diseases and a Chair Professor at the Department of Medicine at the University of Hong Kong, indicated that Hong Kong is currently in the RSV season. Since April, weekly RSV cases have increased by more than 70%, with the infection peak expected in July and August. He reminded that individuals over 60 years old and those with chronic conditions such as diabetes are high-risk groups, as they are more likely to develop severe symptoms or even die following an RSV infection.

What is RSV?

RSV is a common respiratory virus that infects the nose, throat and lungs, typically causing mild, cold-like symptoms in healthy individuals. RSV spreads through droplets such as when an infected person cough, sneezes or talks. At room temperature, RSV in the secretions of patients may survive on nonporous surfaces, such as countertops, for 3 to 30 hours. It survives on soft surfaces like cloth and paper tissue for a shorter amount of time. Therefore, the virus could also be transmitted via direct contact with contaminated surfaces.

People with RSV are usually contagious for three to eight days. They can be contagious a day or two before they show symptoms. Babies and people with weakened immune systems who get the virus can spread it for up to a month.

Some people might ask: How can you distinguish between RSV symptoms and those of the flu? In fact, RSV infection typically begins with nasal congestion and runny nose, which is quite different from the common flu symptoms of general fatigue, muscle aches, sore throat, and cough. The general weakness and cough associated with RSV usually become more noticeable after the nasal symptoms appear. Additionally, the rate of fever in RSV infections is generally less than 50%, and the fever temperature rarely exceeds 39°C. In contrast, the fever rate for the flu is about 75%, with temperatures reaching 39-40°C. Finally, RSV infections are less likely to involve gastrointestinal symptoms, whereas the flu more often includes gastrointestinal discomfort.

Impact on the Elderly and Young Children

For certain populations, including infants, the elderly, and individuals with compromised immune systems, RSV can cause severe bronchiolitis and pneumonia, leading to hospitalization and, in some cases, fatalities. In infants, RSV is a leading cause of lower respiratory tract infections and is responsible for a substantial number of hospitalizations each year.

Recent studies have indicated that RSV has a substantial impact on older adults, often leading to more severe infections than influenza. Studies show that older patients hospitalized with RSV have longer hospital stays, higher risks of pneumonia, bacterial superinfection, ICU admission, repeat hospitalization, and increased in-hospital and 1-year mortality rates compared to those hospitalized with influenza.

Professor Hung warns that the mortality rate for elderly patients infected with RSV is significantly higher than for younger populations. Specifically, older adults have a mortality rate 100 times higher than younger individuals when infected with RSV. Additionally, the virus can cause functional decline and worsen existing health conditions like congestive heart failure, chronic obstructive pulmonary disease (COPD), and diabetes.

Seasonality and Challenges

RSV typically peaks between April and November in Hong Kong, but disruptions in its seasonality due to factors like the COVID-19 pandemic have led to off-season outbreaks. Due to this unpredictability, Dr. Hung emphasizes the need for year-long surveillance to monitor and respond to RSV effectively.

In June 2023, the United States Centers for Disease Control and Prevention (CDC) recommended that adults aged 60 and older receive a single dose of the RSV vaccine. Public awareness campaigns, continuous medical education programs, heightened awareness and proactive measures are crucial to mitigate the spread of the virus and reduce RSV-related morbidity and mortality.

Moreover, RSV is highly contagious, with each infected infant potentially transmitting the virus to four other infants. This can lead to cluster infections in places such as postpartum care centers and daycare facilities.

The Importance of Disinfection & Indoor Environmental Hygiene Monitoring

Given RSV's ability to survive on surfaces for several hours, disinfection plays a crucial role in preventing its transmission. Regular and thorough disinfection of high-touch surfaces in homes, schools, and public spaces can significantly reduce the spread of RSV. Here are some essential steps to consider:

Use Effective Disinfectants: Employ hospital-grade disinfectants capable of eliminating RSV from surfaces. Products such as Nanocyn, Evicate-Pro and Nature Guardian are very effective to kill RSV, offering a safe and reliable hygiene solution to homes and workplaces.

Clean High-Touch Areas Frequently: Focus on disinfecting surfaces that are frequently touched, such as doorknobs, light switches, countertops, and electronic devices. Regular cleaning can help break the chain of transmission.

Promote Hand Hygiene: Encourage regular handwashing with soap and water for at least 20 seconds. Hand sanitizers with at least 60% alcohol can be used when soap and water are not available.

Educate and Inform: Raise awareness about RSV and the importance of disinfection through educational campaigns. Informing the public about proper hygiene practices can lead to more diligent efforts in maintaining clean environments.

Implement Indoor Environmental Hygiene Monitoring in Public Spaces: For businesses and public facilities, conducting regular and rigorous indoor environmental hygiene assessment is vital. Avalon Steritech’s IEH assessment is designed to detect the existence of a wide range of bacteria and viruses so that more targeted preventive and remedial measures could be taken to avoid an outbreak.

By understanding the risks and taking proactive steps, we can better protect vulnerable populations and reduce the overall impact of RSV to public health.

Sources: https://www.ohsu.edu/health/rsv-respiratory-syncytial-virus; https://www.hkmj.org/earlyrelease/hkmj245156.htm; https://health.ettoday.net/news/2756025;  https://www.kinderclinic.com.tw/content-44.html