VSyncytial irus, Covid and flu: how to deal with this year protect the health of children? This is the question that many parents are asking themselves and to which the paediatricians, gathered in Turin at the 78th Congress of the Italian Society of Pediatrics.
According to experts, it is not yet clear whether the “triad” will accompany the season with peaks at different times or whether an overlap should be taken into account, just as there are no estimates, at the moment, on what it will be the extent of circulation of these viruses.
On the basis of what has been observed in the other hemisphere, as regards the respiratory syncytial virus (RSV), the peak should arrive later than last year, but there are no certainties. How much to the fluthe ECDC (European Center for Disease Control and Prevention) did not comment on the fare predictions about the severity of this season compared to last year.
So how can parents act to protect the health of their little ones in view of the winter? Here are some useful tips.
Beware of syncytial virus
Last year there was abronchiolitis epidemic due precisely to respiratory syncytial virusa virus widely spread globally, which It can be transmitted at any age, but is more aggressive in younger children. Could a similar situation arise this year?
«The respiratory syncytial virus is a very common virus, as the preferential transmission route occurs through contact with infected secretions or through droplets (droplets of saliva) that we emit when we speak or cough – explains the Dr. Elena Bozzola, National Councilor of the Italian Paediatrics Society. – Respiratory syncytial virus is estimated causes approximately 33 million cases of infection in children aged 0-5 years worldwide every yearbeyond 3 million hospitalizations and 120 thousand deaths. In Europe the data we have tells us that every year There are approximately 20,000 hospital admissions among children under 5 years of age due to respiratory syncytial virus. The virus represents the most frequent cause of respiratory tract infection in children under 2 years of age and the first cause of hospitalization under one year of age”.
The situation before and after Covid
«During the pandemic since Covid 19, in Italy as in many other countries, the respiratory syncytial virus has not been talked about, but then returned to circulate together with the other viruses, once restrictive measures ended – continues the expert. – In the autumn 2021 a occurred almost double the number of hospitalizations for RSV bronchiolitis compared to pre-pandemic periods. Probably due to the easing of virus containment measures. The hospitalizations in 2022-2023in similar numbers to the previous year, were mainly caused by new genetic variants of the virusassociated with a circulation advance and a greater severity of the disease, when compared to that of previous seasons. Especially for the need for respiratory support and hospitalization in intensive care. It is still early to make predictions for the 2023-2024 season, although the data available so far they seem to lean towards a gradual return to a pre-pandemic situation».
Syncytial virus: who is most at risk
As regards RSV, we know that the risks, i.e. the danger of it evolving into bronchiolitis, mainly concern younger children.
“The RSV can affect anyone. This is a fact. Currently, i subjects most at risk of severe form are newborns and infants under 6 months of age. It is in this age group that 74% of hospitalizations occur. In particular, 46% concern the youngest children under 3 months” – Dr. Bozzola further specifies.
How to recognize bronchiolitis
For this reason, it is important to pay attention to alarm bells in the little ones. «At the beginning, bronchiolitis is like a flu illness – also underlines Fabio Midulla, President of the SIMRI (Italian Society of Childhood Respiratory Diseases) and Professor of Paediatrics at the University of Rome La Sapienza. – So, the child may have a cold, cough and a little fever. The most important thing is to check nutritionThat begins to reduce 24 hours before the onset of respiratory distress. If the little one begins to don’t eat, you have to be careful, that’s the alarm bell. Normally the most serious symptoms appear between the third and fifth day.”
Syncyntial virus: there is no vaccine
It should then be specified that There is not yet a vaccine for this type of virus.
«There is only one monoclonal antibody currently authorized in Italy in very selected cases – explains Dr. Bozzola. – That is to say severe preterm infants, bronchopulmonary dysplasia, or haemodynamically significant congenital heart disease. They represent a minimum percentage of patients. There the majority of those hospitalized are children born healthy and/or full term, not eligible for current Palivizumab prophylaxis. This means that approximately 90% of patients requiring hospitalization are currently healthy and born full term. From here the call for new protection tools, which could include a monoclonal antibody for all newborns, a vaccine to be administered during pregnancy (maternal immunization is universally recognized as an effective strategy to reduce the vulnerability of newborns and infants in the first few months of life) and a pediatric vaccine.”
Flu and children: how to deal with it
In the case of theflu, on the other hand, there is a vaccine: but how to deal with children? And what is the right time to do it?
“This It’s the right time to get vaccinated against the flu because the first cases have already been recorded – underlines the SIP National Councilor. – Flu vaccination comes above all recommended for pregnant women, children aged between six months and six years and fragile children for concomitant pathologies or therapies they are taking. It’s still important also consult your pediatrician to receive personalized advice. Evaluate thethe opportunity of the intra nasal vaccine as an alternative to the intramuscular one and maybe organize the vaccine directly in his office».
Flu and covid: what is the situation?
Even for Covid, at this moment, “there are reports of cases of variable severity, which are often managed at home, even if we have not yet seen widespread circulation – says Susanna Esposito, coordinator of the infectious diseases technical table of the SIP and professor of pediatrics at the University of Parma. – At the moment these cases have a limited quantitative weight, but it must be remembered that the epidemiological situation can change rapidly and you have to be prepared.”
Flu and Covid: very similar symptoms
In the presence of symptoms in children such as a cold, cough and a little fever, is it always useful to take a swab to understand if it is flu or Covid?
«Covid and flu are very similar viral diseases, especially in the symptoms and their manifestation especially affecting the respiratory tract with rhinitis, cough and pharyngitis and any associated systemic symptoms such as general malaise and high fever – explains Dr. Bozzola. – As for the Eris variant, the most common symptoms are truly comparable to those of the flu. These include sore throat, runny or stuffy nose, cough, headache, hoarse voice, muscle and joint pain. Therefore, the only way to exclude of being positive for Covid always requires a swab test”.
If the child is positive for Covid
“In a circular from the Ministry of Health, replaces isolation, with the provision, if you test positive in a molecular or antigen test, to wear a respiratory protective device (surgical mask or Fff2), if you come into contact with other people – concludes the expert. – If you are symptomatic, it is best to stay home until your symptoms subside. Always valid indications remain those of respecting correct hand hygiene and avoiding crowded environments”.
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