The origin of the virus, treatments, hospitalization … What you need to know about bronchiolitis

As an indication… the bronchiolitis epidemic is where it hurts: the lack of resources for the health care system. the increase ‘Missing, fast and early’ Indications of the epidemic, reported by France’s public health authority on Wednesday, are putting pressure on pediatric services. Unlike Covid, health professionals know the disease well but find it difficult to respond to it properly. Family closures, lack of caregivers, and harmful working conditions are all factors that push staff to leave the public hospital. Release Take a look around with the experts.

What is bronchiolitis?

Bronchiolitis is a respiratory disease of the small bronchi, caused mainly by respiratory syncytial virus (RSV), which affects children under the age of two. The most common symptoms are colds and coughs, which can become more frequent. Often, it clears up spontaneously after ten days, although the cough persists. Fever may also be present. Even if it is benign most of the time, it presents a certain risk “For premature babies and those with heart disease or chronic disease,” explanation for Release Professor Olivier Briseau, Head of the Pediatric Intensive Care Unit at Purdue University Hospital.

This disease is highly contagious and transmitted through the respiratory system and through contact with hands – and some things. It is possible to prevent it and reduce the risk by “Wash your hands, wear a mask when you have a cold, and avoid having too many people in the house”says pediatrician Remy Salomon, MD, chief of pediatric nephrology at Necker Infants Malades Hospital.

What treatments?

The most common treatment protocol consists of “Clean the nose and give medicine for fever if there are no respiratory symptoms”, According to Professor Presaud. Things get complicated when a child has trouble breathing. In this case “You have to go to the hospital and give the baby oxygen.”. For patients with severe disease, it is necessary to use “For Invasive Respiratory Aid, With Intubation”. in the hospital, “We don’t give antibiotics unless there is a bacterial infection,” Professor Presaud continues.

To date, there is no actual vaccine against bronchiolitis. On the other hand, the European Union has just approved a preventative treatment, a passive immunotherapy, developed by Sanofi and AstraZeneca. It will be available from 2023. It is the first drug able to prevent severe forms of bronchiolitis in all children, in a single dose. It consists of injecting a monoclonal antibody, that is, synthetic antibodies that are produced in a laboratory. “This new treatment is an important step forward. The advantage is that it has a longer shelf life than the treatment we already know. It has been made in a way that protects the baby for six months, although its effectiveness has decreased from the third month.”Decoding Oliver Brisso.

A preventative treatment is currently available but is intended for at-risk or premature babies: Synargis, marketed by AstraZeneca. Requires one dose per month, from October to February.

Is it an exceptional outbreak?

According to the latest data published by Public Health France, a total of 6,167 children under the age of two went to the emergency room for bronchiolitis in mainland France during the week of October 24-30, an increase of 47% compared to the previous week. . Nearly 1980 of them were eventually hospitalized. “If we rely on the curves of previous years, we would be at the beginning of the peak. It is possible to think that we still have between four and five weeks of the peak. However, it is impossible to say at what date we will start taking the scion, Explains Professor Laurent Dubeck, Head of the Pediatric Beaver Department at Necker Hospital and member of the Inter-Hospital Pediatric Group. It’s a strong year for sure, but it’s not the importance delta that changes the system, it’s the fact that there aren’t enough families. His colleague Remy Salomon corroborates these observations: I am not saying that the winter epidemic is not strong, but it can be managed by more means. We are short of doctors in the city and we have to transport patients because we are exhausted.

“Emergencies are the front door and staff are having a hard time. At Purdue University Hospital, there are between 170 and 190 visits per day. Children are often very small and Their respiratory illness is very severe. The number of hospitalizations increased slightlyProfessor Brysso explains. However, this disease has been known to health professionals for about forty years and they know how to deal with it. “The problem isn’t bronchiolitis per se, what’s wrong with the hospital is dying and needs to be dealt with,” He points out.

Why are hospitals so stressful?

If hospitals are struggling to deal with the surge in cases, it’s not because of the pandemic. For professionals, it has nothing to do with Covid either, it’s always a matter of means. this year Hospitals launched white plans like The situation is almost the same from year to yearProfessor Brysso confirms. The big difference is that in 2022 there are fewer hospital beds left.

In Paris for example, “We will keep children who need resuscitation in classic service while we wait for a place to become available. We have delays in patient care, which makes the situation catastrophic and unsustainable.Sorry, Laurent Dubic. Plus, transfers are not without risks for young patients who need imminent hospitalization and specific treatments. for him, The Presidency of the Republic and the Alliance for the Re-Liberation of Somalia did not hear the warning signs carried by the people on the ground. They warned that we are headed toward a looming situation at best, and at worst catastrophic..