Bronchiolitis, this is how we face the viral pandemic of the little ones

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We have just set foot in December and up to 40% more cases are being treated in some pediatric emergencies than in the pre-pandemic era.

What's going on?

Why this new saturation of the system?

The answer lies, in large part, in the respiratory syncytial virus (RSV): an old acquaintance that causes most bronchiolitis.

.

However, this year leva lián

brown pain since the month of July.

Why do we have VRS running around even when it "doesn't play"?

It is suspected that the coronavirus may have had a lot to do with the

.

Isolation and prevention measures have prevented children from coming into contact with many viruses and this season "they are getting to know each other".

In fact, right now the fear among pediatricians is that, amid so much confusion, it is unknown when the maximum peak will be reached, if the severity of the cases will be greater than in other seasons, or for how many months this epidemic will converge with the infection from other viruses such as influenza or COVID.

There is already talk of "tripledemia": flu, covid and bronchiolitis.

Should we worry?

Personally

.

I think we have already suffered too much for almost three years to now have to torture ourselves with new "words" with apocalyptic overtones.

In addition, it is a confusing term because we are not going through a situation with three pandemics but

common cold and some other bug that walks around clueless.

The problem is that the simultaneous presence of these three pathologies supposes, especially in the pediatric field, a new threat for the care system, which is already harmed.

What exactly is bronchiolitis?

bronchiolitis is the

To understand this we have to go back again to

.

When we breathe, air passes through the respiratory tract: the trachea divides into two bronchi, left and right, which in turn continue to branch like a tree into twigs that are smaller and smaller each time, until they form the bronchioles.

When RSV camps there, it causes inflammation that makes breathing difficult.

This can occur more frequently in younger children (traditionally under two years of age although more cases are now being seen in children under four).

What are the symptoms?

The

and the symptoms resemble those of a

.

Other times,

.

can also have

, decreased appetite, vomiting mucus, or difficulty eating.

It can be a serious disease in premature babies, in infants under 3 months of age, and in children with heart, respiratory, muscular, or immune system problems.

How is it diagnosed?

Is it necessary to do an x-ray to see the bronchioles?

The diagnosis of bronchiolitis is

without the need for a blood test or a chest X-ray.

Only in the event that any complication has been seen, additional tests are done.

What is your treatment?:

The truth is that

.

It's not like a bacterial tonsillitis where you take the antibiotic to kill the bug and

.

The good news is that most bronchiolitis is overcome

(although the cough can last a little longer, even two to four weeks).

As indicated by the Spanish Association of Pediatrics (AEP), treatment, as in almost all viral infections, is symptomatic:

• Remove mucus from the nose with physiological saline or saline solutions.

• Place the baby in a semi-recumbent position, raising the headboard to help him breathe better.

• Offer plenty of water to avoid dehydration and help the mucus to be fluid and better eliminated.

  If you breastfeed, offer frequently.

• It is possible that he has less appetite and gets tired with feedings: in this case it is necessary to offer less and more frequently.

• If you have a fever: avoid overcoating the child and administer paracetamol or ibuprofen (ibuprofen only if the child is older than 3 months).

When do you have to stay at home and when do you have to go to the emergency room?

According to the Spanish Society of Pediatric Emergencies (SEUP), you have to go to the emergency room...

• If the child is in poor general condition, irritable, sleepy.

• If he gets very tired with feedings, he hardly eats.

• If it turns purple or pale.

• If your breathing is worse: you are breathing faster and faster, your ribs are marked, your abdomen moves a lot, your chest sinks or you stop breathing for seconds.

How is bronchiolitis spread?

RSV is very contagious.

It is transmitted through the saliva and mucus of the infected person:

• In the aerosols or droplets that are generated by breathing, coughing, sneezing...

• By touching surfaces or objects where RSV can remain for hours (pacifiers, toys...) and then touching the child's mouth, nose or eyes.

How can we prevent it?

Some of the measures will sound a bit familiar to us:

• frequent hand washing

• Use disposable tissues

• Do not take children to nursery school while they are sick

• Keep adults with respiratory infections away from the child, even if it is a mild cold

• Avoid tobacco smoke and crowded environments

• Breastfeeding protects against viral infections, including bronchiolitis

• In some children at risk of severe bronchiolitis, palivizumab can be administered: These are antibodies that bind to the RSV virus to prevent the disease from occurring or to make it milder.

  It is administered intramuscularly in the thigh once a month during the winter months (maximum 5 doses).

  It is hospital administration.

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