• Several regions are in the pre-epidemic phase of bronchiolitis.

  • Every year, it affects 30% of children under 2 years old.

  • To protect toddlers from this disease, barrier gestures are essential.

She didn't wait to show up.

With an increase in contaminations and hospitalizations, bronchiolitis, a respiratory disease which affects babies and can sometimes lead them to hospital, has already begun to rage in France.

While it traditionally reappears in the fall, it appears to be making a comeback earlier than last year, prompting doctors to fear an early outbreak.

How to explain it?

Can the disease be prevented?

Can a major epidemic still be avoided?

Several regions in pre-epidemic phase

For the moment, if it is too early to speak of an epidemic, the last days have been marked by the "continued increase in the monitoring indicators of bronchiolitis in children under 2 years old", indicates in its latest weekly Public Health France report.

Common and highly contagious, “bronchiolitis is an acute respiratory viral infection affecting the bronchioles (small bronchi).

It is most often due to the respiratory syncytial virus (RSV), which causes inflammation of the walls of the bronchioles (the smallest bronchi) and an increase in secretions responsible for a phenomenon of obstruction, ”describes the Health Insurance.

It "affects infants (under 2 years old) and is characterized by an episode of respiratory discomfort, the signs of which are coughing and rapid, wheezing breathing".

In practice, several regions have entered the pre-epidemic phase: Hauts-de-France, Île-de-France, New Aquitaine and Occitanie.

In total, 1,491 children under the age of 2 went to the emergency room for bronchiolitis in the week from September 26 to October 2, up 41% compared to the previous week, observes Public Health France, which specifies that nearly 500 children were hospitalized.

“We are starting to see the first babies affected by bronchiolitis in consultation, confirms Dr. Sylvie Hubinois, pediatrician, president of the French Association of Ambulatory Pediatrics (AFPA).

It is not yet a peak of contamination, the month of October generally marks the appearance of the first cases, ”she tempers.

The figures are also similar to those observed last year at the same time, in a context then marked by the end of confinements linked to Covid-19.

“Last year, there were a lot of cases because the children had not been able to immunize themselves the year before, remembers the pediatrician.

The epidemic had started in September 2021”.

An early epidemic in perspective

But if there is not yet a crowd in the pediatric practice, the number of hospitalizations higher than what is generally observed raises fears of an early epidemic.

In general, it starts at the end of October, reaches a peak at the end of December, then ends at the end of March.

And the younger the babies, the more impressive the disease can be.

“The profiles most at risk are premature babies.

We advise not to put them in community the first year, in particular because of viral epidemics, including bronchiolitis, indicates Dr. Hubinois.

As well as toddlers with respiratory illnesses and infants under three weeks old.

But they remain very fragile in the face of bronchiolitis until the age of two to three months”.

“The serious forms are seen especially during the very first months”, added Rémi Salomon, president of the Medical Commission for the establishment of the AP-HP, on Twitter on Saturday, recalling that “the epidemic of bronchiolitis has begun”.

A message of prevention “all the more important since the pediatric services are very saturated”, he insists.

And that bronchiolitis is extremely contagious.

“Adults and older children who carry respiratory syncytial virus usually have no signs or just a cold.

Thus, many people carry the virus and are contagious without knowing it, recalls the Ministry of Health.

The virus is easily transmitted through saliva, coughs and sneezes.

And "can remain on hands and objects (such as toys, pacifiers or comforters)".



Prevent the disease (barrier gestures, it works)

To keep bronchiolitis at bay, but also Covid-19 and winter viruses, there are no secrets: barrier gestures must – again and again – be required.

“The first measure is to ensure that babies at risk of a severe form of bronchiolitis do not catch it, insists Dr. Hubinois.

So you have to be vigilant with the rest of the siblings who go to school or nursery, where viral diseases have been circulating since the start of the school year.

Then, hand hygiene is fundamental, you have to wash them well before and after the change, and before breastfeeding or bottle feeding, ”prescribes the pediatrician.

But also “by opening the windows of the room where the baby sleeps at least 10 minutes a day to ventilate, adds the Ministry of Health.

By not sharing bottles”, or even “regularly washing toys and comforters”.

And if the parents have a cold, you have to "cover your mouth when you cough or sneeze, and wear a mask when you take care of your baby".

Another common sense measure that is easier to prescribe than to apply: “avoid kissing the baby on the face and on the hands” if you are sick.

And the pandemic has shown that these recommendations work: “two years ago, during confinement and before vaccines were available, barrier gestures and distancing measures were scrupulously respected, and there was no bronchiolitis epidemic that winter,” recalls Dr. Hubinois.

Each year the virus affects 30% of babies, or about 500,000 children.

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