ISS: «For now no anomalous increase; if a new virus were to emerge, the surveillance system would be able to detect it”
Following the alarm over the pneumonia epidemic in China and the hypothesis that these are infections caused by mycoplasma pneumoniae – but infections caused by respiratory syncytial virus and C0-infections are also on the increase -, we asked the expert what I am, how pneumonia is prevented and treated
mycoplasma pneumoniae and from respiratory syncytial virusas well as how to avoid the possible ones risks arising from
“mixed” infections.
What is Mycoplasma pneumoniae bacterial infection?
The pediatrician and infectious disease specialist Guido Castelli Gattinara, of the Institute for child and adolescent health of the Bambino Gesù pediatric hospital in Rome, member of the technical table on infectious diseases of the Italian Society of Paediatrics (Sip), explains: «Theinfection is due to a bacterium – mycoplasma – “atypical“because it lacks a cell wall, which has the ability to bind to lung tissue and cause a form of atypical pneumonia.”
Transmission of the infection
How does contagion happen? «The bacterium enters the lungs by air, transmitted through “droplets” of saliva or breath (droplets) in the air spread by infected people” explains the pediatrician and infectious disease specialist. «It is a germ that we know, also present in Italy, and it is more easy for it to be transmitted in “closed” communitiesas for example in schools. It affects small but also older children (it is more frequent among those of school age, between 6-7 years old) and adults.”
Symptoms e diagnosis
What are the symptoms? «The clinical manifestation is the pneumonia (atypical) usually characterized by little fever (in some cases it is high), from little dry cough (in some cases however it lasts a very long time); the child, then, is asthenic that is, weak, and has signs of general malaise. These symptoms, if they last over time and get worse, they can cause significant pneumonia that requires hospitalization.”
How to recognize it this atypical pneumonia? «In these forms there is no nasal discharge (rhinitis), nor the red throat – clarifies Professor Castelli Gattinara -. The advice, especially if fever and cough last over time, is to contact the family paediatrician, who will visit the child and evaluate whether to have more in-depth tests carried out. School-age children often have so-called “community” pneumonia which rarely becomes serious.”
How do you arrive at the diagnosis?
Castelli replies: «To make a certain diagnosis, in-depth investigations are needed such as chest x-rays and specific tests to identify the presence of the mycoplasma via a nose/throat swab and a PCR (Polymerase chain reaction) test”.
Therapies
As for therapies, the infectious disease specialist stated: «We know that the Antibiotics have a defense function against bacterial infections and not viral infections, but unfortunately, all over the world as soon as a child has a fever, antibiotics are given, and this has led to an increase in drug resistance. Pneumonia gives m
ycoplasma pneumoniae safe not with classic antibiotics but with specific antibiotics called macrolideswhich act inside the atypical bacterium (which does not have a cell wall ed) – specifies the expert -. Unfortunately, these antibiotics have also been used recklessly, even in Italy, and recent scientific data tell us that resistance to these antibiotics is on average above 50%, in some countries it is higher andIn China it even reaches up to 97 percent. The antibiotic, the right one and in the right dosage – underlines the infectious disease pediatrician once again – must be prescribed by the doctor”. So no to do-it-yourself.
How to prevent mycoplasma pneumonia?
«Meanwhile, one form of protection is to get all the recommended vaccinationsincluding the flu vaccine (in pediatric age recommended for children from 6 months to six years and, for “fragile” ones, even after the age of six, ed) – advises Castelli –. Another feature of this mycoplasma is associated with viral diseases;
in the most severe forms – which may require hospitalization – we often find a co-infection of more than one agent infectious (virus or bacterium), i.e. lMycoplasma infection is particularly serious when there is also a viral infection, whether due to respiratory syncytial virus, or influenza virus (not to be underestimated, since it still causes between 6-8 thousand deaths a year in Italy alone)”.
Other forms of prevention (valid for all airborne infectious diseases)
Other ways of protection are the ones we learned to use during the pandemic. Professor Castelli reminds her: «Maintain the distance by people who cough and have a cold (however you have to cough and sneeze into the crook of your elbow, ed); to wash hands often, before eating and touching your mucous membranes, and when you return home; use of mask in crowded places or if you live with people who have respiratory diseases. They are all systems that serve to prevent all infectious diseases that are transmitted through the air».
Respiratory syncytial virus, what it is, how to prevent it
“The respiratory syncytial viruswhich strikes mainly in winter (unlike mycoplasma which also strikes in summer), had almost disappeared during the Covid-19 pandemic but, as soon as the restriction measures endrecorded a increased diffusion, greater than in the past – recalls Professor Castelli –. This virus can do serious damage especially in premature or fragile children – for example, with pulmonary, cardiac or neurological pathologies – and also in the elderly. Against the syncytial virus antivirals do not work And does not exist still on the market a vaccine in childhood . So, for the most fragile young children gods must be activated prevention systems by administeringin the winter period, specific monoclonal antibodies (in hospitals and vaccination centers).”
Syncytial virus infection, symptoms and what to do
In the unfortunate event the respiratory syncytial virus should infect
the child, How can you recognize it and what to do? «The virus affects the lungs and creates an inflammation (edema) of the wall of the mucous membranes of the small bronchi of the lung, the bronchioles, hence the name of the disease “bronchiolitis” – explains Professor Castelli -. As for clinical manifestationsUsually there is no fever, but the child has a cough and, above all, has difficulty breathing (with polypnea, i.e. increased respiratory rate) and has intercostal indentations i.e. ago struggles to expand the lung to let in air. Respiratory syncytial virus infection, which is diagnosed by your pediatrician, does not usually occur particular gravity characteristics; if, however, the clinical manifestations they get worseThe b
child is dejected, he doesn’t eatit even comes to have cyanotic bluish lipsit is advisable to take him to hospital because intensive therapy may be necessary (especially for fragile children).”
Also in this case it is necessary to adopt, starting from the family, all the necessary precautions to protect the child especially if fragile, with the recommended prevention measures.
More dangerous co-infections
The expert further underlines: «The co-infections they are the ones who characterize the most serious diseasesso the precautions towards various infections, including influenza and Covid, which if associated with another infection (especially if the lungs are affected), can give serious clinical manifestations. Furthermore, it should be remembered that many infections such as mycoplasma, syncytial virus, influenza, Covid itself, can be acquired even asymptomatically, so they can be transmitted to children and fragile people. Hence the importance of prevention” concludes the expert.
Risks in Italy? The response of the Istituto Superiore di Sanità
What is the situation in Italy regarding pneumonia? What if, instead, a new virus were to emerge? Says theHigher Institute of Health to the Courier Health: “The surveillance system of respiratory diseases RespiVirNet is fully operational and monitors trends in the country thanks to the network established with the Regions with the support of the Ministry of Health which involves family doctors and paediatricians. THEn case of anomalous increases – the ISS explains further –
is able to detect them and, should a new virus emerge that needs to be accounted for, the system is capable of doing so. The trend in this period is one increase in flu-like syndromesas is normal as the cold season progresses».
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November 23, 2023 (modified November 23, 2023 | 7:18 pm)
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