PANIC!

01.14.14

Suffering From An ‘Incurable Respiratory Disease’ This Winter? Relax. It’s Just RSV.

When “the news” warned us of an “incurable respiratory disease” infecting loads of sick kids, we asked the Beast’s resident doctor to tamper down the hype. Everybody relax. It’s just RSV.

If you sneezed, you might have missed this one.

According to a tweet by CBS Evening News, a Houston hospital is “inundated with sick children suffering from an incurable respiratory disease.” The network refers its readers to the Twitter account of their Chief Medical Correspondent, Dr Jonathan LaPook, a gastroenterologist in New York City for more. But unless I missed it, Dr LaPook has yet to sign in on the crisis. (The full story is here).

Yikes, you may be thinking—sick children? Incurable disease? Jesus where can I get my kids vaccinated? Or should I put a paper bag over their head? Or just go hide somewhere?

But relax! There is no real there there. Sorry, CBS. Twitter,  which was created, we had hoped, by the sound bite age for the sound bite age to prevent the sound bite excesses of the sound bite age, has backfired once again in creating what appears to be another tempest in the Twitter teapot.

The “incurable respiratory illness” is respiratory syncytial virus (RSV), a well-known winter scourge that strikes every year with varying severity. It is technically “incurable” but incurable in the same way that colds have no cure and sprained ankles have no cure. The word in a headline is used to grab the eye, not define treatment options.

According to the CDC, on an average winter RSV sends more than 100,000 small children and another 177,000 elderly to the hospital and accounts for more than 1.5 million out-patient visits. It also results in 14,000 deaths among those older than 65 years. The CDC has tracked RSV for years.

This season, the uptick started around Thanksgiving and seems to be ticking ever more upwards since—it may indeed be a bad year. According to experts in Houston, it surely is shaping up that way in Texas— and as a guy who right now has a barking cough, low-grade fevers, some chills and sweats, as well as an insatiable urge to sleep 23 hours a day, I suspect it is widespread here in Manhattan as well.

RSV is one of many viral respiratory infections that resemble influenza—a confluence that makes public persuasion about taking the influenza vaccine so difficult.  The influenza shot is only protective against influenza, but not RSV or the half-dozen other similar infections that cause the aches and coughs and sniffles that make winter particularly uninviting.

In addition to RSV, the other viruses include human metapneumovirus (HMPV), parainfluenza which despite its name is not that closely linked genetically to influenza, and the groups of “cold” viruses, rhinovirus and coronavirus, that can make a person feel mighty bad.  Plus, as we learned from SARS and more recently from MERS, the Middle Eastern Respiratory Syndrome virus, both coronaviruses, even the relatively wimpy coronas can, under certain conditions, become lethal.

“It is technically ‘incurable’ but incurable in the same way that colds have no cure and sprained ankles have no cure.”

Plus there surely are more still unnamed viruses out there. In recent high-end series using fancy molecular diagnostic techniques, efficient labs and willing patients, a virus can be found in only 75% of all “colds” and “flu-like illnesses.” In other words, more now-unnamed viruses are waiting to give you a bad day or two or three— and convince you that that influenza vaccine you had was worthless because it affords no protection against the other infections. And on average, adults develop about four viral respiratory illnesses a year—four times for people to erroneously feel that their influenza shot let them down. The reason for their winter-time predilection remains unclear: closed windows, tight quarters, low humidity, insufficient vitamin D…the theories abound.

The medical focus on influenza— in addition to being the only one with an effective vaccine, it’s the only one that has an antiviral medication approved for treatment— is because it kills far more people than the others. Plus it typically is a 4-5 day illness with higher fevers and more misery than the other respiratory viruses.

Which still fails to explain why CBS so willingly pumped up the panic about a routine, if serious, infection in Houston. Surely there was enough other news out there with Chris Christie unbound, Ariel Sharon buried, and the Golden Globe Awards full of subtle slights and winks in need of deep consideration. But then nothing sells like illness and the more awful, the more dangerous-seeming, the better.

Because as CBS and so many other news outlets looking for a quick splash have shown us, in the world of infectious disease, the infection is not the only thing that is contagious.

Editor's Note: Due to an editing error, a gastroenterologist's name was misspelled as LaPoo. It is LaPook. We regret the error.