When her infant son developed a stuffy nose and cold-like symptoms, Kirsten Hokeness, Ph.D., and her husband attributed it to having traveled for a recent vacation. It wasn’t until he became lethargic and exhibited discolored skin that the family ended up in the emergency room one Sunday.
“His O2 stats were down in the 80s, which was bad,” recalls the School of Health and Behavioral Sciences director. “These stats measure how much oxygen is going through your body to your tissues, so anything below 90 isn’t good.”
Hokeness says a team of doctors rushed in to give her son oxygen and determine the source of the problem. The family soon learned that he had contracted the respiratory syncytial virus (RSV).
“RSV is a very common respiratory infection that is passed along via air droplets,” says Hokeness, an immunologist whose research focuses on virology, microbiology, immunology, and human health and disease. “When you cough or sneeze, those droplets are filled with the virus, so you can acquire it through breathing it in. RSV also stays alive on surfaces for a few hours, which babies or parents could end up touching.”
The virus mimics the common cold, with symptoms of a low-grade fever, mild coughing, sneezing, and a stuffy nose. In the northern hemisphere, RSV cases primarily occur between October and April with peak infection rates from November through January; like a typical virus, RSV lasts anywhere from seven to 10 days.
Infants and individuals 60 and older are the most suspectable to the virus. According to the Centers for Disease Control and Prevention, each year RSV leads to 58,000 to 80,000 hospitalizations and 100 to 300 deaths among children younger than five years old and 60,000 to 160,000 hospitalizations and 6,000 to 10,000 deaths among adults 65 and older.
Hokeness’ son spent several days in the intensive care unit where doctors used deep suctioning to clear his airways. While she describes the situation as touch and go for a little while, he soon recovered but was left with several long-term effects.
“One of the things that can happen, particularly in babies whose lungs aren't fully developed, is damage from inflammation in the airways that can cause lasting wheezing,” Hokeness says, noting that her son developed recurrent respiratory infections and exercise-induced asthma that required him to have an inhaler until age six.
Today, Hokeness’ son has grown into a smart, kind, and super witty 11-year-old who plays the piano, loves to cook and — like most kids and adults — hates doing laundry. He’s also doing great post-RSV.
“He has grown out of his exercise-induced asthma and plays on several basketball and soccer teams. He made the middle school soccer team, and his AAU basketball team starts play in a week,” Hokeness says, adding that he is a fierce competitor and leaves everything on the field or court every time he plays.
While RSV infects virtually all children by age two, premature babies, children younger than 12 months, and those with weakened immune systems or neuromuscular disorders are at greater risk for more severe reactions. Hokeness notes that prior to 2023 there had not been an approved vaccine for RSV. In May, the Food and Drug Administration approved two vaccines for adults ages 60 and older — with one vaccine later receiving the go-ahead for pregnant mothers.
“For pregnant women particularly, this vaccine is important because they're going to be handling newborn babies. It's a very common virus, so being able to protect yourself and your baby is vital,” Hokeness says, adding that those who are 60 and older are entering the grandparent stage and can use the RSV vaccine to protect themselves and their young grandchildren.
In addition to the new vaccines, the FDA also gave the greenlight on monoclonal antibodies to help protect infants. According to the administration, these laboratory-made proteins mimic the immune system’s ability to fight off harmful pathogens.
While assisting vulnerable populations is a vaccine’s goal, this new breakthrough can help limit hospitalizations, after-impact treatments, morbidity, and healthcare costs.
“The healthier we can keep ourselves, the less strain we put on already-stressed hospitals as well,” Hokeness says.