Every year the known as respiratory syncytial virus (RSV) causes a pediatric epidemic of cases of acute bronchiolitis in children under two years of age that primary care and pediatric hospitals in Spain collapse. However, due to the Covid-19 pandemic, this year there have been hardly any cases of this disease in its usual stage.
The epidemic of acute bronchiolitis in infants It usually appears in late October or early November and lasts until February. However, SARS-CoV-2 displaced VRS, a winter respiratory virus, and what has been seen for a few weeks in pediatric emergencies is a rebound in cases throughout the country.
How does this condition affect the little ones? Where are you from?
“Acute bronchiolitis is colloquially known as young children’s bronchitis”, point to 20minutos the Dr. Antonio Moreno, coordinator of the pediatric pulmonology area of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). It is “an inflammation of the bronchi, airways and fundamentally of the finest ones called bronchioles“, adds the expert in pulmonology.
RSV is the cause of 60-70% of all cases of acute bronchiolitis.
This infection mainly affects children under two years of age and the virus that causes 60-70% of all cases It is the respiratory syncytial virus (RSV). “All other respiratory viruses such as rhinovirus, adenovirus, metapneumovirus or enterovirus can also cause this disease, but the most important is RSV”, clarifies Dr. Moreno.
In this sense, although children between one and two years of age usually suffer from it, “normally half of those who enter are under six months old and, above all, under three months old“He details. That is why it is essential to adopt preventive measures to avoid contagion by this virus, especially in newborns, due to possible health complications.
What are the warning signs?
The first symptom that children may experience after being infected with RSV is a cold accompanied by mucus. “After two or three days he begins to breathe with difficulty, he does not eat well, his ribs sink and you can hear respiratory noises that we normally call crackles and other times wheezing,” the doctor details.
“In some cases they can have a high fever of up to 39 degrees or higher.”
Also, acute bronchiolitis can manifest with fever, as with any other respiratory virus, or with a slight low-grade fever. “In some cases they may have a high fever of up to 39 degrees or higher, since each child reacts in a different way, “he clarifies.
Thus, the first warning signs may be nasal congestion or coughing for a few days, as if it were a common cold, “and then the child is likely to park, not getting worse, or to start coughing more, breathing more quickly and with difficulty “, they emphasize from the Spanish Society of Pediatric Pulmonology (SENP). The noises are also characteristic because “the bronchi are obstructed by inflammation and by the mucus secreted by the disease itself.”
“RSV can also affect older children or adults with bronchitis or asthma attacks.”
Does this virus also affect adults?
As Dr. Moreno clarifies, the word acute bronchiolitis is used to refer to this bronchitis in children under two years of age, but “RSV can also affect older children or adolescents, which can cause bronchitis or asthma attacks, and adults. “Thus, it can cause bronchitis, asthmatic episodes and even pneumonia, “especially people over 65 and pregnant women.”
According to Mayo Clinic specialists, RSV often causes cold-like symptoms in older children and adults such as the following: Nasal congestion, dry cough, sore throat, mild fever, sneezing, or headache.
“The mechanism by which children are infected is because older people catch a cold from this virus.”
Nevertheless, the usual epidemic every year is the one that occurs in pediatrics, since in most cases this virus usually generates a common cold in adults. In fact, “the mechanism by which young children are infected is because older people catch a cold from this virus and from this they transmit the virus that results in pictures of bronchiolitis in small“, underlines the coordinator of pediatric pulmonology of SEPAR.
In this way, RSV enters the body “through the eyes, nose, or mouth” and “it is easily transmitted through the air in infected respiratory droplets,” they add at Mayo Clinic. Therefore, anyone can become infected if someone with the infection expels these drops through coughing or sneezing, mainly.
What are the consequences of infection? Does it generate complications?
Mild acute bronchiolitis usually lasts three to five days in most cases, but there may be patients with a more severe clinical picture than require hospital admission for oxygen administration. After hospitalization, minors usually recover well and without any other medical problems.
“50% are more likely to have repeated bronchitis during the first years of life.”
However, “50% are more likely to have repeated bronchitis during the first years of life because the bronchi remain inflamed and are more sensitive to other respiratory viruses“, warns Dr. Moreno. This depends on the level of severity of bronchiolitis and the age of the patients, since the youngest are more at risk of suffering repeated episodes of bronchitis.
In these cases it is likely that during the months or years after the disease, “colds present with symptoms similar to those of initial bronchiolitis, that is, cough with or without fever, shortness of breath and wheezing in the chest “, they add in the SENP.
How is the treatment? Is there a cure for RSV?
This disease in infants usually lasts a few days and heals by itself, since “it does not have any specific treatment and there is no medicine to cure it,” emphasizes Dr. Moreno. A) Yes, the evolution is spontaneous, as occurs with similar conditions such as the flu.
However, while children have the disease, health professionals offer supportive measures and support for their well-being. Some guidelines offered to parents for mild bronchiolitis are as follows:
- Superficially clean the nasal passages to clear the nose and breathe better.
- Maintain adequate hydration, especially if there is a fever.
- Aspirate nasal secretions.
- Help them eat fractionally in smaller amounts to prevent fatigue or tiredness.
- Do not smoke in or near the home.
“If the clinical picture is more serious and they have more difficulty breathing, they may have to go to the hospital and administer oxygen. Some children even have to go to the intensive care unit for this disease “, warns the expert.
How can RSV infection be prevented?
To avoid acute bronchiolitis due to RSV in children under two years of age or colds and bronchitis in older people, it is essential to adopt hygiene measures, such as those currently being implemented with the pandemic of the coronavirus.
Above all, it is necessary to adopt these measures with children who are less than three months old. “That people who have a cold do not go to see them, that safety distances are maintained, that people wash their hands before, that they do not smoke and that if someone has any symptoms put on a mask “, recommends the doctor.
Hygiene measures are the same as those used to prevent coronavirus.
Before the pandemic, these hygiene measures were not strictly complied with, but “they are the same as those recommended to prevent Covid-19 and that prevent these cases of RSV from spreading among children,” he concludes.
From the Spanish Society of Pediatric Pneumology offer the following guidelines and recommendations:
- Avoid taking children under three months or who have been premature to daycare, as much as possible.
- Proceed to frequent hand washing with soap and water, especially after arriving from kindergarten or school.
- Make sure that babies are not in contact with people who have a cold.
- Prevent the little ones from spending a long time in medical consultations.
- Avoid going to crowded places, such as buses or shopping centers.
- Bronchiolitis is transmitted through respiratory droplets, so it is important that anyone who handles a baby’s utensil or toy wash their hands.