Pediatricians worry ‘increased number of hospitalizations and severity’ of RSV cases in children

National Institute of Health Dr. Ricardo Jorge had already warned of an increase in hospitalizations due to respiratory syncytial virus infection, which arrived earlier this year and leaves hospital pediatrics “under pressure”.

During October, 41 children were hospitalized with respiratory syncytial virus (RSV), accounting for 66.1% of hospitalizations in children under two years of age with acute respiratory infection (which was 62 in total), according to the latest. INSA . Reportfor the week of October 24-30, which contains data from notifications submitted by hospitals in the VigiRSV – Respiratory Syncytial Virus Infection Surveillance Project.

The trend towards new infections and hospitalizations in this age group is on the rise and is already causing restrictions in some hospitals. At Professor Dutor Fernando Fonseca Hospital, in Amadora, CNN Portugal knows the pediatric service is full, but vacancies are being increased to prevent an increase in hospitalizations, that’s what reveals the source of this hospital.

In last week’s reportNational Institute of Health Dr. Ricardo Jorge had already warned of an “increased number of hospitalizations due to respiratory syncytial virus infection in children under two years old,” but such hospitalizations are occurring earlier than usual and cases are more serious, Manuel Ferreira explained to CNN Portugal. Pediatric pulmonologist at Centro Materno Infantil do Norte, in Porto.

“It is undoubtedly a very significant increase, both in number and intensity. We are talking about infections, especially in children, in the first year of life, the episode of hospitalization in the intensive care unit. [unidade de cuidados intensivos]’, he explains.

Alberto Caldas Afonso, Director of Centro Materno Infantil do Norte, confirms that this unit of the Centro Hospitalar Universitário do Porto houses “a significant number of young children”. [que ainda estão a ser amamentando] in the hospital with RSV” and that “the epidemic has changed the epidemiological peak”, as well as the immunity of people, including children. “In the post-isolation period, that is, last year, in August, there were cases of bronchiolitis that remained in the same period as before The pandemic,” he says, explaining that, as it happens now, “everything has to do with the immune stimulating system, which hasn’t gone into effect” and which consequently makes children “more vulnerable to coming into contact with these agents.”

“In the pre-pandemic period, cases of this kind appeared in December and January. This year it happens from October, and we have a huge impact on situations that indicate hospitalization. And what happens in pediatric emergency rooms is a completely atypical movement, with a large number of people going children to the emergency room. But, fortunately, the vast majority have no indication of hospitalization.”

A source from Santa Maria Hospital, in Lisbon, also confirmed the increase in the number of hospitalizations due to this virus, noting that “all hospitals were under great pressure” and that “there are a very large number of bronchiolitis” associated with this virus. The same source notes that the scenario was usual in all winters preceding the pandemic, but “this year started earlier.” And the INSA report only shows itself: Currently, the infection and hospitalization rate for this virus (week 43) has exceeded the levels recorded in the 46th week of last year, corresponding to November 15-21, which indicates the arrival of the virus a month ago. .

For Manuel Ferreira Magalhães, the fact that we are seeing an earlier peak than in the pre-pandemic years is due to the pandemic itself, which changed the ‘seasonal’ for this and other respiratory viruses. In the case of RSV, this is usually common “between November and March”, but this year in October there was an increase in the number of cases and hospitalizations.

“There was a very significant reduction in the spread of the virus, and the children were not exposed to modifying their immunity for it, but there is no 100% response,” he adds.

In the case of Hospital São João, in Porto, during October, 29 pediatric patients were hospitalized with viral respiratory infections. Of those, six per VSR. The rest are other viruses: the noseinfluenza, a parainfluenza,” the hospital explains to CNN Portugal.

CNN Portugal contacted other hospitals from north to south of the country to find out the status of beds assigned to children in hospitals, but did not receive a timely response.

What is this virus?

In the past year – since the first week of October 2021 and the last week of October 2022 – there have been 285 reported cases of hospitalization with respiratory syncytial virus. About 42% of cases were less than three months old, 15% were premature and 14% had low birth weight. In terms of risk criteria, 11% were admitted to intensive care units or required ventilation (non-invasive/conventional),” the INSA report notes.

Respiratory syncytial virus is a so-called bronchiolitis virus, says Manuel Ferreira de Magalhães, and there is no “special treatment,” “which is a problem.” “It’s just waiting for it to pass,” he continues, although he says it can be very painful for children, especially children who can’t pass phlegm on their own. “[O vírus] Babies fill with secretions, and there isn’t much way to prevent that from happening.”

The Respiratory Syncytial Virus Surveillance Network (VigiRSV) has 19 public hospitals and one private hospital and has focused, above all, on children under two years of age, but Manuel Ferreira Magalhães warns that this virus does not choose ages and that more elderly people appear to be under Rahma’s early and intense work this year.

The doctor talks about “cases of seriously ill elderly people with RSV”, which he says is “tragic”, and urges “attention” to the fact that “RSV infections are transmitted from children to the elderly and they are becoming more severe” Will.”

For Caldas Afonso, “there is no reason to panic,” not least, he says, “part of immune growth,” but he recognizes that this situation deserves attention and even measures to avoid an escalation of hospitalizations. At this point, it is suggested that schools and kindergartens not only allow “boys to pass pacifiers from one to another, to put toys in their mouths”, but also that caregivers and teachers (in daycares, kindergartens and schools, as well as at home) “wear a muzzle” if they show Picture of a respiratory infection.