Two infections posing severe risks for senior citizens

[WORLD] As we age, our bodies become more vulnerable to various health challenges, including infections that may seem harmless in younger individuals. Two such infections that disproportionately affect senior citizens are shingles, caused by the varicella-zoster virus, and respiratory syncytial virus (RSV). These conditions can lead to severe complications in older adults, making it crucial for seniors and their caregivers to understand the risks and available preventive measures.

Shingles: The Dormant Virus That Awakens

Shingles, a painful skin condition, is caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. It's estimated that around 90% of adults aged 50 and above have been infected with this virus. Dr. Elisa Turriani, GSK RSV Global Medical Affairs medical director, explains, "What most of us don't know – and what I didn't know until I started working on this – is that you continue to get RSV throughout your life". This statement, while referring to RSV, also applies to the varicella-zoster virus, which remains dormant in our bodies after a chickenpox infection.

The Reawakening Process

The varicella-zoster virus lies dormant in our sensory nerves after a chickenpox infection, waiting for an opportunity to resurface. As we age, our immune system weakens, providing the virus with the perfect chance to reactivate. This reactivation leads to shingles, a condition characterized by extremely painful blisters along nerve pathways.

Risk Factors for Shingles

The risk of developing shingles increases significantly with age, especially after 50 years. Other factors that can increase the likelihood of shingles include:

• Compromised immune system (e.g., HIV and cancer patients)
• Autoimmune diseases (e.g., rheumatoid arthritis and inflammatory bowel disorder)
• Chronic conditions (e.g., diabetes, heart disease, asthma, and depression)1

The Impact of Shingles on Seniors

For senior citizens, shingles can be particularly debilitating. The pain associated with shingles can be severe and long-lasting, sometimes persisting for months or even years after the rash has healed. This condition, known as postherpetic neuralgia, can significantly impact quality of life, leading to depression, anxiety, and sleep disturbances.

Prevention and Treatment

While there is no cure for shingles, vaccination can significantly reduce the risk of developing the condition. A new shingles vaccine, launched in Malaysia in September 2024, has shown remarkable efficacy:

• 97% effective in preventing shingles in those aged 50 to 69 years
• 91% effective in those aged 70 and above1

Long-term follow-up studies have demonstrated that the vaccine's efficacy remains high at 82% for adults 50 years and older, even 10 years after vaccination.

Respiratory Syncytial Virus (RSV): A Silent Threat to Seniors

RSV is often associated with infant and childhood infections, but it poses a significant risk to older adults as well. This highly transmissible virus can infect up to three people from a single infected individual.

The Impact of RSV on Seniors

While RSV infections are usually mild in healthy adults, they can lead to severe complications in older individuals. Dr. Turriani explains, "And as we get older, the fact that we continue to get the disease actually can become quite dangerous – because as we get older, our immune system ages and we are more likely to get a severe RSV infection".

Complications of RSV in seniors can include:

• Pneumonia
• Exacerbation of chronic conditions like asthma and heart disease
• Hospitalization
• In severe cases, death

Research indicates that older adults are being hospitalized and dying from RSV at far higher rates than young children. However, these statistics may be underreported as older patients are less likely to be tested for RSV infection.

RSV Seasonality and Risk Periods

In temperate countries, RSV seasons typically start in autumn and last until the end of winter. However, in Malaysia, the threat of RSV persists throughout the year, with peak periods in July-August and October-December. This extended risk period makes prevention strategies particularly important for seniors in tropical climates.

Prevention and Vaccination

Recent advancements in vaccine development have led to the introduction of an RSV vaccine targeted at adults aged 60 and above. This vaccine, launched in Malaysia in September 2024, has shown promising results:

• 82.6% protective effect against lower respiratory tract disease (e.g., pneumonia) for healthy adults aged 60 and above after one RSV season
• 94.6% protection for adults aged 60 and above with one or more concurrent medical conditions1
• However, it's important to note that the effectiveness of this one-dose vaccine decreases over time. After the third RSV season, the efficacy drops to:
• 48% for healthy adults
• 57.8% for those with at least one comorbidity

The Importance of Vaccination for Seniors

Vaccination plays a crucial role in protecting senior citizens from both shingles and RSV. As our immune systems weaken with age, vaccines become even more critical in preventing severe infections and their complications.

Shingles Vaccination

The new shingles vaccine offers a high level of protection that remains effective for many years. Seniors should consult their healthcare providers about getting vaccinated, especially if they fall into high-risk categories.

RSV Vaccination

The recently introduced RSV vaccine for adults aged 60 and above provides significant protection against severe RSV infections. While its effectiveness may decrease over time, it still offers valuable protection, particularly for seniors with underlying health conditions.

Lifestyle Factors for Boosting Immunity in Seniors

In addition to vaccination, seniors can take several steps to boost their immune systems and reduce the risk of severe infections:

• Maintain a balanced diet rich in fruits, vegetables, and lean proteins
• Stay physically active with regular exercise appropriate for their fitness level
• Get adequate sleep and manage stress levels
• Practice good hygiene, including frequent handwashing
• Avoid close contact with individuals who have active infections

The Role of Healthcare Providers

Healthcare providers play a crucial role in protecting senior citizens from these infections. They should:

• Educate seniors about the risks of shingles and RSV
• Recommend appropriate vaccinations based on individual health profiles
• Monitor seniors for early signs of infection
• Provide prompt treatment when infections occur to prevent complications

Shingles and RSV pose significant health risks to senior citizens, but with proper awareness, prevention strategies, and medical interventions, these risks can be minimized. Vaccination stands out as a key tool in protecting older adults from severe infections and their complications.

As our population ages, it becomes increasingly important to prioritize the health and well-being of our senior citizens. By understanding the unique challenges posed by infections like shingles and RSV, we can work towards ensuring a healthier, more comfortable life for older adults.

Remember, prevention is always better than cure. If you're a senior citizen or care for one, consult with a healthcare provider about vaccination options and other preventive measures against these potentially severe infections.