For bronchiolitis, whose main etiological agent is the respiratory syncytial virus, cortisone, antibiotics and bronchodilators are not needed. To say it are the new guidelines of the Italian Society of Pediatrics (Sip).
Who is most at risk during epidemics
In the last 2 years in Italy and in the world there have been heavy epidemics of bronchiolitis which have put health systems in difficulty due to the saturation of beds in the wards and in intensive care units. Most hospitalizations concern infants in their first year of life.
Children, without a mask, risk new epidemics of respiratory syncytial virus
by Alessandra Volpe
The new guidelines for therapies
Today Italy, in order to contrast this virus that has put Italian pediatricians in trouble, also due to the concomitance with the flu epidemic and Sars-COV-2, is adopting new guidelines that aim at uniformity and standardization treatments and correct information to parents. The guidelines, created with the aegis of the Italian Society of Pediatrics (SIP), the Society of Neonatology (SIN), the Society for Childhood Respiratory Diseases (SIMRI) and 13 other pediatric scientific societies, were just published on theItalian Journal of Pediatrics and update those of 2014, in the light of the latest scientific evidence.
“This document – underlines the President of the Italian Society of Pediatrics Anna Maria Staiano, among the authors of the paper- is published at a time when the health service has been put to the test due to this virus. It is therefore important to provide pediatricians who work in the area, in hospitals and in the emergency departments, with an update on best practices for the management of bronchiolitis with the hope of arriving at a common and shared medical approach”.
The triplendemic of children, what it is and how to defend them
by Donatella Zorzetto
The pandemic linked to Covid has led to drastic changes in the epidemic curve of this virus which, Sip underlines in a note, infects more than 60% of children during the first year of life. The public health measures imposed by various countries including Italy, in particular the lockdowns and school closures, social distancing, more frequent hand washing and the use of masks, first led to a drastic reduction in the number of cases of bronchiolitis, and therefore hospitalizations worldwide, and then a resurgence of respiratory syncytial virus. When these measures were lifted, we witnessed a drastic increase in the circulation of the virus, with peaks at atypical times of the year and a considerable impact on health services.
Record accesses to the emergency room and pediatric intensive care units in distress due to the respiratory virus epidemic
The scientific publication reiterates that “drugs for which there is no evidence are often used and that these drugs can also cause side effects”, he explains Eugene Baraldi, director of the Women’s and Children’s Health Department of the Padua University Hospital. “Drugs such as cortisone, antibiotics and bronchodilators should not be used, while this still happens often. The Guidelines emphasize the importance of providing information to parents of young children to prevent infection, because in bronchiolitis one of the fundamental aspects is that of prevention, since, in addition to oxygen, there are no antivirals or vaccines available”, adds the expert.
Advice for parents
- Don’t kiss the little ones if they have a cold.
- Use the mask in case of cold when approaching the child. If you have a cold, refrain from kissing him and avoid touching his face.
- Breast milk contains antibodies to many infectious agents and reduces the risk of serious RSV infections and hospitalization for bronchiolitis.
- Wash your hands with soap and water or an alcoholic gel before touching the child and ask other people in contact with the child to do the same.
- Keep your child away from other children or adults with a cold.
- No smoking in the house; smoking increases the risk of infection.
- If the baby is premature or has heart or lung disease, ask the pediatrician if there are indications for the use of monoclonal antibodies to prevent RSV infections.
- All of these measures also help prevent respiratory infections caused by other viruses and bacteria
Testing of drugs and vaccines
From the point of view of pharmacological prevention, there is a monoclonal antibody for RSV already available, Palivizumab, which has been used for many years to protect infants born prematurely. A novelty appearing on the market is a new monoclonal antibody which could be given to all infants for universal prophylaxis. Such a strategy could contain seasonal RSV outbreaks and hospitalizations. Then there are several vaccines under study, but they are more distant in reaching the clinic, the application.