Bronchiolitis in children: "Up to 40% more admissions than before Covid in some ERs"

• Doubts What is bronchiolitis: symptoms, causes and treatment

• Health The respiratory syncytial virus and influenza A are anticipated in a winter that will have more "respiratory processes"

The respiratory virus season gains strength with the arrival of the cold.

And after two years with Covid as the protagonist, it is the turn of the usual ones: respiratory syncytial virus (RSV), flu, pneumococcus... Specifically,

, it is already the second wave that he experiences.

After an unusual one that took place in August, another one arrives in the autumn, more powerful than usual and which accumulates cases of newborns and young children who, due to the pandemic, have not been exposed to this type of pathogen in recent years.

The Spanish Society of Pediatric Emergencies (SEUP), a specialty society integrated into the Spanish Association of Pediatrics (AEP), has expressed in a statement its "concern and uncertainty about the unexpected increase in the volume of care in pediatric emergencies throughout the Spanish territory in recent months and the delays that it is causing in patient care. The situation has reached the point that

."

"

. What we are seeing is an accumulation of many cases, with the

and if that peak is going to be higher than in other years, as has happened in countries of the Southern Hemisphere", points out Federico Martinón, head of the Pediatrics service at the Clinical Hospital of Santiago de Compostela.

"That is why contingency measures must be taken in the face of possible scenarios of an even higher occupancy than the usual saturation that we had before the pandemic during the VRS season," he underlines.

As he explains, this resurgence of

is due to a combination of different factors.

"Like other viruses, such as influenza, RSV did not circulate normally in previous seasons, probably due to competition from SARS-CoV-2 itself and also due to

".

Due to these circumstances, an 'immune gap' has occurred, that is, an accumulation of people who are susceptible to the virus, vulnerable, who have not been previously exposed to it.

"

, because it is not only newborns this year who are susceptible, but also those born last year and the year before, who had not previously had contact with the virus," explains the pediatrician.

In any case, he adds, the children most at risk of complications are infants under three months of age, so many of the new infections will not be serious.

Along the same lines, Amparo Larrauri, head of the Influenza and other Respiratory Virus Surveillance Group of the National Epidemiology Center (CNE) and researcher at the Carlos III Health Institute (ISCIII), in a recent meeting with the media organized by

."

"Yes, it is true that it draws attention because this virus behaves more explosively, with many cases. Yes, we are seeing hospitalization rates that increase significantly week by week," she stressed.

Francisco Pozo, senior scientist at the CNE Reference Laboratory for Influenza and Respiratory Viruses and an ISCIII researcher, added that this is not an exclusive phenomenon in Spain, but "that

."

Bronchiolitis and the healthcare burden in the system

Globally,

.

RSV is estimated to cause approximately 34 million lung infections and 3.2 million hospital admissions each year.

Recently, Martinón's team has participated in a study that has analyzed the healthcare burden that care for this type of infection entails in Europe.

According to their data, published in

journal ,

.

The incidence of viral infection, according to this study that followed up 9,154 children born between July 2017 and April 2020, reached 26.2%.

.

Chest X-ray showing hyperinflation with flattened diaphragm and bilateral atelectasis in a 16-day-old newborn.EM

The conclusions of the research indicate that vaccinating pregnant women or babies during their first year of life could help to significantly reduce the health burden associated with this type of infection.

, although according to the Galician pediatrician, a product is being developed for pregnant women that would also offer protection to the newborn.

"As already happens with the flu or whooping cough vaccine,

of life, which is when he is most vulnerable and the infection has more serious consequences," says Martinón.

In addition to this passive immunization strategy,

, "which could

and has been shown to work in infants It is administered in a single dose and lasts about five months," says Martinón, who has participated in the drug's clinical trials.

To date,

, such as premature babies or those with heart disease.

RSV, the wave of viruses that precedes the flu epidemic

In addition to RSV, there has also been a significant increase in cases of influenza and other respiratory viruses, according to data from the Acute Respiratory Infection Sentinel Surveillance system in Primary Care (ARIs) and in Hospitals (ARIG) Influenza, COVID-19 and other respiratory viruses (SiViRa).

The rise of the three viruses occurs above all in the 0-4-year-old group with a 17% RSV positivity rate, 10.9% in influenza and 17.9% in SARS-CoV-2 in the week of November 10.

The RSV rate in Primary Care stands at 75.7 cases per 100,000 inhabitants

.

By age group, the highest RSV rates occur in the 0-4 year-old group, with 945.7 cases per 100,000 h.

And it is in this group of minors

followed by those over 79 years of age, 4.4 cases.

With the SiViRa data, in the last week

.

The percentage of positivity this week, calculated in those networks that have the number of tests carried out, stands at 12%, increasing compared to the previous week when it was 10%.

According to the criteria of The Trust Project

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• Pediatrics

• Respiratory diseases