Bronchiolitis: after COVID, the fear of a rebound

After the cloak due to COVID, the countries of the northern hemisphere are preparing for this winter for a possible rebound of bronchiolitis, a respiratory disease that affects babies and can sometimes lead them to the hospital.

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“The bronchiolitis epidemic could be large,” warns in its latest opinion the Scientific Council, which guides the French government.

Last winter, confinements and anti-COVID barrier gestures also blocked other viruses, including RSV (respiratory syncytial virus), responsible for bronchiolitis.

The children were less infected than usual, and therefore have less immunity. The French Scientific Council thus notes a “significant acquired collective immunity deficit for children born after March 2020”.

“The low circulation of RSV during fall / winter 2020-21 may increase the risk of serious illness associated with RSV in infants and young children due to low levels of exposure to the virus last year,” the Spanish Society of Neonatology (Seneo) was also alarmed in mid-September.

Common and highly contagious, bronchiolitis causes babies to cough and difficult, fast, and wheezing.

Even if it is distressing for young parents, it is most of the time benign. But it may require a visit to the emergency room, or even hospitalization. A large-scale epidemic could therefore weigh on hospital systems already strained by COVID.

“We have already noticed an increase in the number of cases. These days we have hospitalized a few newborns who have been placed on oxygen ”, told AFP Antonino Reale, head of pediatric emergencies at the Bambino Gesu hospital in Rome, reference in Italy for child care and new -born.

However, “this is a small signal that is still too weak to say how winter will unfold,” he adds.

Same observation and same caution in France. For the week of September 27, there were 1,278 emergency visits of children under 2 years of age for bronchiolitis, of which 460 resulted in hospitalization, against 700 and 300 respectively at this time in a normal year.

“The level of indicators remains moderate”, but we observe a “tendency to increase which requires the greatest vigilance”, explains to AFP Delphine Viriot, epidemiologist at the health agency Public Health France.

“The idea is to be able to detect the onset of the epidemic as early as possible, to enable the organization of hospital services to be set up,” she adds.

For this, we have “a good reference”, because in normal times, the epidemic of bronchiolitis follows the same pattern from one year to the next: it starts at the end of October, reaches a peak at the end of December then ends at the end of the year. March.

But last winter, COVID turned that timeline upside down.

In addition to being less strong (2,500 weekly emergency visits in France during the peak against 5,000 in a normal season), the bronchiolitis epidemic has been shifted in time: it “started at the beginning of February 2021, with a peak at the beginning of April, then at the end of early June, ”notes Delphine Viriot.

This is also what happened in Australia.

At the end of 2020, that is to say in spring / summer in the southern hemisphere, several Australian states noted an unusual increase in cases of bronchiolitis, attributed to the easing of anti-COVID measures.

“Although respiratory illnesses are more common in the cooler months, the lifting of restrictions and the increase in social interactions may have contributed to this unusual increase for the season”, assured the state of New Wales. -South in a press release on December 10, 2020.

“What causes concern, it is especially the very young”, underlines with AFP the Dr. Fabienne Kochert, president of the French Association of ambulatory pediatrics (Afpa), by recommending “a rigorous respect of the barrier measures”.

“We must not take babies under 3 months in supermarkets, and we must keep a minimum of distance,” she insists.

Kissing babies should be avoided: if it is due to RSV, a cold in an adult can lead to bronchiolitis in a little one.


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