Background and Aim
Respiratory syncytial virus (RSV) is a highly infectious respiratory virus which causes significant morbidity and mortality. While RSV burden in infants is well documented, data describing adult RSV infection—particularly among Aboriginal and Torres Strait Islander People are limited. The Northern Territory (NT) of Australia has the highest proportion of Aboriginal people in Australia (31%), who generally have higher rates of comorbidities and poorer health outcomes than non-Aboriginal Australians.
Methods and Analysis
We conducted retrospective cohort study on all adult notifications of RSV in the NT from 1 July 2021 (when it became notifiable)to 30 June 2025. We defined severe infection as infection resulting in hospitalisation and/or death. We performed multivariate logistic regression analysis to identify risk factors for severe RSV infection.
Outcomes
Of 4,738 RSV notifications across all ages, 2,021 (43%) occurred in adults; 31% of were severe infection. Aboriginal adults were more likely to experience severe RSV infection compared with non-Aboriginal adults (adjusted OR 3.9, 95% CI 2.8–5.4, p value?). Older age (aor, 95% CI, p value) and remote residence (aOR, 95% ci, p value) were also independently associated with severe disease. RSV notifications occurred year-round with no consistent seasonal pattern.
Conclusion and Future Actions
RSV causes substantial morbidity and mortality among adults in the NT, with disproportionate impact on Aboriginal people. We recommend adult RSV vaccination to reduce incidence and severe infection in the NT, particularly for Aboriginal people, older adults, and those living in remote areas.