In winter, pediatric hospital wards are usually overwhelmed by epidemics of bronchiolitis, gastroenteritis and influenza.. “Usually, we don’t have enough space to accommodate young children who have severe forms and who suffer from severe dehydration in particular. Emergencies are under pressure and we are sometimes forced to deprogram operations. This is not the case this year ”, rejoices Fabienne Eymard, health executive at Timone children, in Marseille. The same goes for Gironde, where Dr. Jean-François Pujol, a liberal pediatrician and hospital practitioner, practices: “There are very few cases of acute infections whereas normally a good third of our beds are occupied by bronchiolitis. “
According to Public Health France, 179 children were hospitalized from January 11 to 17, 2021 against 979 at the same time last year. In fact, the map of France showing the regional alert level for bronchiolitis in children under 2 is to date completely green, whereas it is traditionally scarlet red. In general, consultations due to viral diseases (ear infection, nasopharyngitis, influenza, chickenpox, etc.) have thus decreased for several months. “From 50 to 60%”, says Robert Cohen, infectious disease specialist and president of the National Union of Hospital Pediatricians.
Barrier gestures also act as a barrier to other viruses
“The barrier gestures that protect us against Covid-19 are extremely effective in blocking seasonal viruses that are transmitted through the respiratory tract and digestive tract, analyzes epidemiologist Pascal Crepey. The same phenomenon had already been observed to some extent during the H1N1 influenza pandemic in 2009. ”
“I often see children of 4 or 5 years rubbing their hands with gel hydroalcoolique, describes Fabienne Eymard. Smaller, of course, is not recommended, but we adults now wear a mask and wash our hands more regularly: all this helps to fight against epidemics that affect children but also adults. “
Indeed, the sentinel network responsible for the continuous surveillance of the various epidemics in the general population indicates, for the week of January 11 to 17, an incidence rate in metropolitan France for acute diarrhea (gastroenteritis) of 87 cases. per 100,000 inhabitants (compared to 349 at the same period in 2020) and 32 cases per 100,000 inhabitants for influenza (81 per 100,000 in 2020).
“It is the lack of immunity that plays on the scale of an epidemic”
Can this lull in seasonal epidemics last? For this year, Pascal Crepey is optimistic. “The peak of bronchiolitis epidemics is usually reached in mid-December. It is rather fixed in time, to three weeks, indicates the epidemiologist. The flu rate can vary from year to year, so an influenza epidemic in the coming weeks is still possible but it remains relatively unlikely ”.
However, caution will be required for next winter “If we want to relax the barrier gestures, which we all hope”, tempers Doctor Cohen. According to him, future epidemiological episodes may even be more important. “It’s like we have a debt to pay. In 2020, we had 60 or 70% fewer cases of chickenpox, which means that many children were not infected. The same goes for bronchiolitis or gastroenteritis. We can clearly see it today with the Covid: it is this lack of immunity that plays on the scale of an epidemic “, he explains.
The debate on non-compulsory vaccines relaunched?
“When a child has not gone to a nursery, he is often ill during the first year of kindergarten, abounds Jean-François Pujol. There is therefore a break-in of the immune system, which only occurs in contact with the surrounding viruses and microbes. “
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Therefore, Professor Cohen pleads for discussions around non-compulsory vaccines for children to be relaunched. “There is no vaccine against bronchiolitis but there is one against rotavirus gastroenteritis and another against chickenpox. Both are not on the list of 11 mandatory vaccines for babies and children. But they could make it possible to anticipate the backlash linked to the extremely calm situation we are experiencing today. “