“With the reopening of schools there is the risk that the peak of respiratory viruses”, which is leading to an increase in cases among children in recent days, “may continue. Much will also depend on the climate. Viruses circulate when it rains and is humid. What would I tell parents? To avoid sending children to school if they are not perfectly healed, and to pay close attention to primary prevention. In other words, not to forget what we have learned from Covid and from the lockdowns” experienced in the acute phase of the pandemic. This is the message of Fabio Midulla, president of Simri (Italian Society of Infantile Respiratory Diseases), head of the pediatric department emergency at the Umberto I Polyclinic in Rome.
Among the preventive measures that parents should never give up on, the expert highlights to Adnkronos Salute in particular “wash your hands often at home, and use a mask if you have a cold. That is – he explains – if a mother has a cold and cough and has to breastfeed her baby, it is useful for her to wear a mask. The goal is to avoid infecting other people, transmitting fewer germs to those around us, it should be used this way. Other relevant aspects are obviously encouraging breastfeeding in the case of breastfed babies, and avoiding passive smoking. But hand washing is the most important thing – reiterates Midulla – because contagion occurs above all with the larger droplets of saliva that are on the hands”.
When to let children go outside after a respiratory infection? “What I say is that the child should avoid going indoors where there are other people if he is still cold or has a cough. So, sending him back to nursery 'with ongoing symptoms' is not a good thing for other children But if he doesn't have a fever and it's a beautiful sunny day, he can go out and nothing happens to him. In fact, it's better to be outdoors than indoors”, says the pediatrician.
These days “we are at the center of the peak of the epidemic of respiratory diseases also for children, not just for adults. We have many cases of bronchiolitis, we have children who have acute episodes of asthmatic bronchitis, pneumonia. But basically bronchiolitis is the most frequent disease and one that particularly clogs up emergency rooms. The three viruses that are circulating are: the respiratory syncytial virus (Rsv) in first place, followed by influenza and the Sars-CoV-2 coronavirus in more or less the same quantity”.
As a result, “emergency room visits have tripled in the last month. And 90% of the children admitted to our department are children with bronchiolitis. Children who need intravenous fluids, oxygen, who cannot stay at home” , goes on.
“Even in our emergency room there is a particular influx of children – he explains to Adnkronos Salute – The respiratory syncytial virus”, with the bronchiolitis it causes, “is what is dominating, even if there are also cases of Covid in children. But the Rsv virus is more serious and more pathogenic in children than the Sars-CoV-2 coronavirus.”
Covid in this phase in pediatric age “is never serious, RSV is more so, for which we have returned to the pre-pandemic period. If during Covid the bronchiolitis had disappeared, in the season immediately after we had seen a preview of two months of the peak and the beginning of the infections, and in fact at that time the bronchiolitis had already started in September. Now we saw the first cases in mid-November and the peak is now, in December-January. It's an intense peak because there are many children who then come to the emergency room and who need intensive care. We will see the comparison data with pre-Covid at the end of the season.”
Meanwhile, what we see is the concrete implication, namely that in hospitals “we have many” baby patients. “In our emergency room – calculates Midulla – every day we have at least 10 children who need to be hospitalized, there is a very high turnover between those who leave the hospital and those who are hospitalized”. And, therefore, he explains, “we have blocked scheduled hospitalizations, i.e. those of children with chronic diseases who have to undergo “planned” surgical operations, “to give children with bronchiolitis the opportunity to be hospitalized. At the moment we are managing the situation. But we have particular expertise in bronchiolitis and when we see that the peak of the symptoms has improved we send the children home, having them return to the clinic with an appointment for a scheduled visit in the short term, in order to carry out the follow up and follow them until they don't heal.”
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