07/15/2024 – 20:21
The Unified Health System (SUS) recorded 153,000 hospitalizations of babies under 1 year old due to respiratory problems – such as pneumonia, bronchitis and bronchiolitis – in 2023, the equivalent of 419 hospitalizations per day. This is the highest number recorded in the last 15 years, and is 24% higher than the amount recorded in 2022.
The data is part of a survey by the Child Health Observatory (Observa Infância), an initiative of the Oswaldo Cruz Foundation (Fiocruz) and Unifase (Petrópolis School of Medicine).
According to the study, Brazilian history reveals a drop in hospitalizations of babies due to respiratory diseases until 2016. From that year onwards, however, the data began to vary according to the region.
In 2020, with the COVID-19 pandemic, the numbers fell again and substantially, around 340%, but the scenario changed in 2021. Since then, the increase in hospitalizations has been constant.
For infectious disease specialist Rosana Richtmann, there are several factors contributing to this increase in numbers, including the pandemic itself. This is because, as many babies born during the period of social isolation did not have contact with the viruses circulating in the air, there is a build-up of children who will have their first infection now.
“Every time there is a pandemic, we expect an accumulation of cases of babies with respiratory problems in the following years. Those children from the 2020 and 2021 generation did not develop antibodies to extremely common viruses, such as respiratory syncytial virus (RSV), influenza and SARS-CoV-2 itself. Then, in 2022 and, especially, in 2023, there is an accumulation of the cohort of children who are being born and those who are also making their first contact with the virus,” he explains.
As a consequence, there is an increase in both the number of milder cases and those that require hospitalization, since the first infection is usually more serious.
The infectious disease specialist also states that access to diagnosis of some diseases has increased, which may contribute to the increase in infection records. For example, molecular tests that identify viruses have become more popular.
“We used to call the respiratory syncytial virus a virus or pneumonia without an agent. We started to give viruses a name and surname, which is very important,” he says.
Furthermore, the specialist highlights the favorable climatic conditions for the increase in respiratory infections. Fires and other forms of air pollution irritate children’s airways and facilitate infections by viruses and bacteria.
The cold is also related to the survival of these microorganisms, which survive and replicate more effectively at lower temperatures.
Not surprisingly, the Observa Infância study showed that the South, where temperatures are lower, and the Central-West, where there is a high incidence of fires, were the regions that presented the highest hospitalization rates last year.
Prevention
There is another important aspect that contributes to the increase in cases and serious manifestations of respiratory diseases in babies: the drop in vaccination coverage. Vaccination against diseases such as influenza, COVID-19 and whooping cough is the main way to prevent many respiratory problems.
Rosana Richtmann emphasizes not only the immunization of children, but also of pregnant women, following the National Immunization Plan (PNI). “A mother who wants a healthy baby in the first six months of life should receive vaccines exactly for this purpose,” she warns.
In this sense, the coordinator of Observa Infância, Cristiano Boccolini, reinforces in a note released by Fiocruz that the vaccine against RSV has already been approved by the National Health Surveillance Agency (Anvisa) and it is important that it be incorporated into the SUS calendar. The virus is one of the main causes of bronchiolitis, one of the respiratory diseases that led to the highest hospitalization of babies in 2023.
In addition to vaccination, other precautions are necessary. Richtmann points out that breastfeeding is essential for children’s immune systems, since the mother passes antibodies to her child through breast milk. It is also important to keep environments clean, free of dirt that could irritate the baby’s respiratory tract. This applies to tobacco smoke, whether from traditional cigarettes or electronic cigarettes, the infectious disease specialist points out.
Finally, the specialist highlights the need to hydrate the child and prevent the baby from coming into contact with people who have not washed their hands and have the flu, including family members.
Richtmann hopes that the record number of hospitalizations indicated in the survey will not be surpassed this year, but he points out that it is still too early to draw conclusions. “But, without a doubt, we are seeing a lot of circulation of all of them (viruses), so we will wait and see.”
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