By Marcos Dominguez. A strange phenomenon of duplicity is being seen this winter in pediatric outpatient clinics. Parents who take their son because he has been with them for several days fever, cough and runny noseleave with one or several recipes and return a week later stating that the boy or girl got better for a couple of days, then got worse again.
If a common illness such as the flu in a young child is an ordeal of worries, care and uncertainty, when it comes in two peaks it multiplies the burden and confusion. In this season when the Covid seems to have finally been tamed, surprises seem to come twice.
Thus, the duo of respiratory syncytial virus (causing bronchiolitis in children under two years of age) and flu occupied a good part of autumn with intensity. Another duplicity has come from the flu itself, which has manifested itself in two well differentiated waves.
The latest surprise has been the abundance of cases of infections that come back when they seem to get better. However, the most experienced pediatricians warn that it is normal and there is no need to be alarmed.
The reason? “Flu can establish continuity, one after the other,” he explains Pedro Gorrotxategi, Vice President of the Spanish Association of Primary Care Pediatrics. The two dominant types, A and B, “do not generate crossed or permanent immunity, so they can be infected immediately.”
The pediatrician recalls the case, a few years ago, of a small town in Guipúzcoa where there were two nurseries. “The flu was passing from one to another: when in one there was type A, in the other there was type B, and vice versa.”
The second wave of the flu is coming to an end. Yeah the first reached its full intensity between November and December and was carried out exclusively by the A(H3N2) strain, this second has reached its zenith in the second half of February and, even being dominated by type B, the subtype A(H1N1) has been growing steadily. Hence double infection has a high probability.
They are not the only viruses present in the Spanish winter, so it is likely that the coinfection could also be due to many other viruses: rhinovirus, coronavirus, adenovius, etc. They can cause flu-like symptoms, which include sudden-onset fever, dry cough, muscle aches, severe malaise, and runny nose.
“People trivialize the flu but this can mean two weeks of fever in a child,” warns the pediatrician Belen Aguirrezabalaga. “If after 4 or 5 days with fever and a period without fever or fever, in 48 hours, it returns, we look for a complication.”
They can be otitis complicated by a bacterial superinfection, “pneumonia, bronchitis, bronchopneumonia… When something like this happens, it is usually a complication and we almost always have to end up giving an antibiotic, unfortunately.”
Aguirrezabalaga recommends, in a case like this, consulting a doctor and warns that this winter is being very intense. “You have to remember that the flu consumes a lot of the immune system, weakens it: the following trimester is complicated, he gets infected with other things, he has otitis, other colds, etc.”