Fatigue, shortness of breath, cough. It is common that with the cold and poorly ventilated environments, the circulation of respiratory viruses increases. Bronchiolitis, caused by the respiratory syncytial virus, is one of the most worrisome to affect babies and children. And this year, the outbreak started earlier and more cases are being observed.
In the City, the increase is 25% compared to the same date last year and 30% higher than the historical average of the last five years, according to the Buenos Aires Health portfolio.
In the province of Buenos Aires, they registered an increase of 20% in relation to the same time of previous years. "There is greater circulation and the season of Lower Acute Respiratory Infections (IRAB) is advanced. In the Province we still have free beds, there is no critical situation. But anyway this week the minister and his team will have meetings with the health secretaries of the 135 districts," referents of the Buenos Aires Health Ministry told Clarín.
From Nación they agreed that not only did the cases increase but that the peak arrived earlier than expected. "Since epidemiological week 10 – beginning of March – an increase in consultations for respiratory symptoms began to be registered. This trend has been consolidated in the current week 20 with a greater circulation of respiratory syncytial virus and an increase in hospitalizations for bronchiolitis; when this seasonal peak usually occurs in week 24, "they said.
In this regard, they stressed that "given the increase in the circulation of respiratory viruses and the consequent increase in consultations for respiratory infections that occur with the arrival of the cold, the Ministry of Health of the Nation carries out actions in an articulated manner with the Province of Buenos Aires and the City to reinforce the containment of the outbreak ".
In this regard, Dario Barsotti, deputy medical director of Garrahan Hospital, explains: "The increase in respiratory symptoms is occurring differently from what happened before the pandemic. This increase came close to epidemiological week 24 and this year we are 25% above that figure in week 20. The same thing happened in the northern hemisphere, mainly in the United States, after the summer."
"Bronchiolitis is a disease that, in general, affects children under two years of age; Children under six months of age may require hospitalization. It is not a particularly malignant disease. Nor does it require large technologies, so in many cases it can be solved in different pediatric effectors and the hospital has the policy of referring those patients who do not have basic pathologies when they only need low complexity. Only a minimal percentage is internalized, "Barsotti details to this newspaper.
Asked about the demand and the conditions to face it, he adds: "This is stressful for the health system, but it is usual in a guard. We are not outdone. Yes, we are under pressure, like all pediatric hospitalization sites, at least in the metropolitan area."
Ricardo Gutierrez Children's Hospital. In the City, they say that cases of bronchitis increased and the peak of the outbreak was brought forward. Photo: Juano Tesone
"There is an excess of patients with lower respiratory diseases. Even if there are difficulties, we can respond. Nor is it an exclusive problem of the public system, private health centers go through the same reality, "warns the director of the pediatric hospital.
Meanwhile, he emphasizes that "all patients who arrive at the health center are receiving the care they need. Bronchiolitis is not treated with any drugs. It only requires ventilatory support, that is, oxygen therapy."
Preventive measures
"There are two fundamental measures to prevent respiratory diseases. On the one hand, doing pediatric controls and vaccinating children, actions that fell during the pandemic. And on the other, ventilate. The cold does not get sick. What makes you sick is the overcrowding. You have to ventilate, clean surfaces very well and avoid sending children to the garden when they are sick, "adds Barsotti.
Pediatrician Angela Nakab, head of the day hospital at Pedro de Elizalde Hospital and member of the Argentine Society of Pediatrics (SAP), confirms the scenario.
"We are seeing many cases of bronchiolitis both in private practices and in public hospitals. This increased viral circulation is thought to have to do with post-pandemic changes. During the pandemic the children were isolated for a long time without contact with other viruses, currently their situation is different and they interact with children and adults, "says Nakab.
He says to pay attention to certain warning signs such as "fatigue, shortness of breath, weakness or high fever." Also if the child "has his ribs retracted or his abdomen is inflated."
There is no vaccine available, so the key is to ventilate the environments, ensure hygiene and avoid meeting people who are with a respiratory condition since a cold in an adult can lead to a more serious picture in a child, continues Nakab.
In this line, it recommends maintaining breastfeeding, keeping environments smoke-free and not self-medicating children.
Actions focused on the AMBA
Through a statement, the Ministry of Health of the Nation said that "with the proximity of the winter season and the increase in circulation of respiratory viruses, the health portfolios called to intensify prevention measures and to apply the influenza vaccine."
As they remarked, the Ministry "has prepared and deployed different actions to respond to the increase in this type of disease, focusing centrally on the AMBA region."
"The health portfolio has acquired and distributed supplies for diagnosis, virus analysis and treatment of respiratory infections from all jurisdictions in the country, both in medicines and new technologies (high-flow cannulas) and equipment (saturmeters)," they reported.
In addition, they work together with jurisdictions in organizing levels of care through the abbreviated hospitalization strategy to respond to the increased demand for care.
As they specified, they are paying special attention "to families at risk to achieve timely diagnosis and treatment and strengthened community actions through territorial agents who carry out an active search and follow-up, together with the health team, of the most vulnerable families and situations of socio-sanitary risk ".
In turn, Garrahan Hospital contracted 20 external beds that are used in patients at lower risk or without basic conditions during the seasonal period under the supervision of professionals. After evaluation, diagnosis and therapeutic indication, patients with mild and clinically stable conditions can be referred to these beds or to other public health centers belonging to the network of pediatric health centers and services.
The importance of vaccination
"The higher incidence of respiratory infections is also explained by the displacement they have suffered in previous years as a result of Covid 19. In Argentina, as globally, the circulation of influenza and other viruses was interrupted with the arrival of the pandemic, especially during 2020 and 2021. After this period, the flu virus circulated again with unusual behavior, so it is important that people who have some risk factor are vaccinated, ideally before the beginning of winter, "they said from the Ministry of Health.
The flu vaccine, available in all vaccination centers and public hospitals in the country, can be co-administered together with the other vaccines of the National Calendar and with the vaccine against Covid 19.
It is indicated for health personnel, pregnant people (at any time of pregnancy), postpartum people (before maternity discharge), girls and boys from 6 to 24 months of age, people from 2 to 64 years with risk factors and general population from 65 years.
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