STORY AND PHOTO BY KAREN BOSSICK

Michael Cascioli thought of himself as being in perfect health.

A two-sport letterman in college, he continued to play baseball and golf competitively when he turned 50, competing in the National Senior Games, the largest qualifying competition in the world.

He’d even been featured in a TV special about senior athletes who are redefining aging.

But at 56 he experienced a tightness in his chest that spiraled out of control rapidly.

“I’d had asthma since I was a child, but I’d learned how to control it, even meeting with a doctor every six months for a review,” he said. “Thinking I might be having asthma, I went to the doctor for a breathing treatment. He sent me straight to the ER and, by the time I made it to the ER, my coughing had gotten extremely violent and my oxygen levels were dropping rapidly.”

Doctors were able to get Cascioli’s oxygen levels back up and send him home that night. But a few days later his wife took him back to the emergency room as his oxygen levels plummeted again and he turned gray.

He wasn’t cognizant of the IV treatments his doctor applied. He was not aware of anything going on around him. When he finally came out of his fog, he didn’t even remember his wife taking him to the ER. All he could do was ask his doctor, “How did I get here?”

“I was on my back for three weeks,” said Cascioli, a teacher-turned-school administrator. “It knocked me out completely. I couldn’t move. I didn’t feel like doing anything. I felt terrible, just terrible--more fatigued than I’d ever been in my life.”

The diagnosis was RSV, a highly contagious respiratory syncytial virus. It can spread through coughs, sneezes and touching a contaminated surface, such as a door handle, then touching your face before washing your hands.

It can cause pneumonia, as well as bronchiolitis--a severe inflammation of the lungs’ small airways.

“We think about it as a disease of infants, but it’s also a disease of adults,” said Dr. Leonard Friedland, vice present of Scientific Affairs and a vaccine researcher at GSK North America. “It can be quite serious in adults, especially in those 50 and older and those with chronic medical conditions.

“Each year about 177,000 adults 65 and older are hospitalized, and 14,000 will die. Those 75 and older are most at risk for severe infections. Also most at risk are those with asthma and diabetes.”

The good news is that there is now an adult RSV vaccine, introduced in 2023, which is covered by most insurance companies, including Medicare and Medicaid programs. It’s recommended for all adults 75 and older and for those who are between 50 to 74 with underlying conditions such as cancer, kidney disease, diabetes, asthma, heart disease and a weakened immune system.

Currently, one vaccine will do you. There are no recommendations at present for booster doses.

“RSV is a virus that affects our lungs and our breathing passageway,” said Friedland, who joined GSK after an academic career at Cincinnati Children’s Hospital and Temple University. “RSV starts with an upper respiratory infection in which someone may experience sneezing, coughing and a fever. As it gets more severe, it starts to affect breathing passageways, lowering oxygen levels so someone finds themselves struggling for oxygen.”

There are no antiviral drugs to treat RSV once infection sets in, Friedland said. The only way to manage it is to prevent it through the vaccine and good hygiene, such as washing hands frequently and avoiding people who are sick.

The virus most often spreads in fall and winter so now is a good time to get the vaccine if you haven’t already had it, Friedland said. A wave of the highly contagious respiratory syncytial virus has already begun to wash over the United States, sending great numbers of babies and toddlers to the hospital.

Cascioli, now 60, says that he and the friends he’s met from across the country at the Senior Games are always focused on making sure they qualify for the national games so they can get together again. And that includes staying healthy for the games, which will be in Tulsa, Okla., next year.

“I’ve been very, very careful protecting myself. I have 11 grandkids and, if any are sniffling or sneezing, I wave at them from a distance to protect myself. If a kid comes up to me at school and wants to give me a high five, I go straight to the sink to wash my hands. And, of course, I’ve gotten vaccinated against RSV.

“It took me six months to get to feeling back to normal after I had that. And I never want to go through it again.”

THREE BRANDS OF RSV VACCINES:

There are three brands of RSV vaccines—Pfizer’s Abrysvo, Moderna’s mResvia and GSK’s Arexvy. All three can be used for older adults; only the Pfizer vaccine can be used for pregnant women.

The vaccine is recommended for pregnant women between 32 and 36 weeks of gestational age.