responsible for more than 34 million lower respiratory tract infections every year. The virus that is currently circulating is aggressive even in children over the age of one. Expert advice
The Respiratory Syncytial Virus (VRS), like every winter season, returned. It is estimated that it is responsible, every year, for more than 34 million lower respiratory tract infections, which for 3 million cases means hospitalization and for 200,000 children, especially in low socio-economic countries or in particularly fragile children, it can be the cause of death. Although it is a viral agent that is particularly aggressive in the little ones, particularly during the first year of life, this year it also affects older children. In our emergency room (ed. Policlinico Umberto I in Rome) we have several children hospitalized with respiratory infections, which are often confused with the flu which in reality is not yet so widespread – he explains Fabio Midulla professor of Paediatrics at Sapienza University and Head of the Emergency Department at the Policlinico Umberto I in Rome. — The virus that is going around now and that infects the most Respiratory Syncytial Virus (RSV) which
d la bronchiolitis
in children under one year of age, but there are also children after one year of age who have significant respiratory forms attributable to the Respiratory Syncytial Virus. Compared to previous years we are seeing an increase in diffusion even in older children.
The first symptoms
Normally theincubation lasts about 5 days, the first symptoms are cold (1-3 days), dry cough and sometimes fever (in bronchiolitis, in most cases, high fever does not appear), then the child may start to have a poor appetite. If the little one starts to eat significantly less or stops eating, you should start to worry, a respiratory problem could appear – explains Midulla. – LThe most important thing to keep monitored is your diet. In fact, a child does not go from having a cough and/or cold to “breathing badly”, first there is always a decrease in appetite. Reduction in feeding is the first early sign that a child may be experiencing significant respiratory problems. This is why, as soon as a child in the first years of life begins to eat less, it is necessary to contact the doctor, the younger the child, the more attentive one must be to grasp this banal but fundamental sign. Most of the children who are admitted to us do not have serious respiratory problems, but a severe form of dehydration caused by the fact that they do not eat and hydrate themselves enough.
Why it is dangerous and how it is transmitted
The VRS is the main agent responsible for
acute viral bronchiolitis, the most frequent infectious pathology that usually affects children in the first year of life (this year also older children) and the first cause of hospitalization in infants. Unlike other pathogens RSV does not confer long-lasting immunity, therefore the same subject can become infected more than once during a lifetime. This is why children become infected more frequently by being in contact with adults or siblings who perhaps have a simple cold. At a preventative level, family monitoring is fundamental, as it is the place where viruses most often roam. If there is someone with a cold in the house, the important thing is to avoid close contact, especially with the little ones in the house, wash your hands well, adopt all those simple precaution rules that we have learned to know during the pandemic and which help to reduce the spread of the virus, including the syncytial one, explains Minnuta. There Main spread occurs by direct contact through the handsless frequently respiratory transmission. On some infected objects and surfacessuch as tables, toys, door handles, the virus can survive for many hoursThis is why correct hand hygiene is essential, not sharing potentially contaminated objects and frequently cleaning surfaces at risk.
Nasal washes and paracetamol in case of fever
Bronchiolitis, in most mild and moderate cases, tends to disappear on its own. In this context the parent has the task of ensuring a correct hydration and nutrition of the child and ensure that the respiratory tract is clean and open, practicing nasal washing several times a day. However, therapy with antibiotics, anti-inflammatories and cortisone is not indicated. The flu virus is less important and serious than the syncytial virus in children. And then there is the flu vaccine which protects. In case of high fever, paracetamol above 38.5 can be used, do not force the child to eat but make sure he drinks a lot, if the child is breastfed, encourage breastfeeding and avoid passive smoking, concludes Minnuta.
How to exclude that the child has COVID (and not bronchiolitis)?
SARS-CoV-2, like other viral respiratory agents, can also cause bronchiolitis in infants, much less frequently than RSV: in case of suspicion, a simple nasopharyngeal swab will be enough to exclude that it is COVID. In any case, whether it is RSV bronchiolitis or a less frequent case of SARS-CoV-2 bronchiolitis, the prophylaxis is the same and the management precautions remain almost identical.
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December 26, 2023 (changed December 26, 2023 | 07:18)
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