Accesses to the emergency department have never been so consistent compared to past years and occupancy of beds close to the highest levels of sustainability. The many respiratory virus infections in children in recent weeks put a strain on the wards in most of the Italian realities. From the Italian Society of Pediatrics (Sip) comes the solicitation to the government for a strengthening of undersized pediatric intensive care units. With more healthcare personnel available and homogeneity of care guaranteed throughout the territory.
The reasons for the overload
The concomitant presence of two aspects motivates overload in care facilities. On the one hand the age of children with respiratory syncytial virus bronchiolitis (Vrs), on the other hand the cases of “co-infections” caused by multiple pathogens that affect the same organism together. Conditions, these, which often require hospitalization, in the most serious cases in intensive care and a considerable organizational effort.
A highly contagious virus
“With the end of the restrictions from Covid-19, without the use of masks, without careful hand washing and without social distancing, it has become inevitable that some pathogens will flourish again with the winter season”, explains Professor Donato Rigante of the Department of Life Sciences and Public Health of the “A. Gemini” in Rome. «In particular, the human respiratory syncytial virus is a highly contagious virus belonging to the paramyxovirus family, very widespread in winter in all latitudes. It is the leading cause of bronchiolitis and pneumonia in children under the age of two.
Over 3 million hospitalizations from Vrs worldwide
«The name of the virus derives from the tissue cultures infected with this pathogen, whose cells tend to fuse together, generating a conglomerate (or a “syncytium”)”, adds the pediatrician. “Co-infections” with other viruses (for example influenza, but also metapneumoviruses, rhinoviruses, adenoviruses and so on) can be observed during epidemics, such as this winter, but are generally less frequent. “Globally, over 3 million pediatric hospitalizations are attributable to RSV: this infection is mostly universal within the age of two, therefore more or less all children are involved”.
Treatment of complicated cases
However, the severity of this pathology which can lead to occlusion of the small bronchi and respiratory insufficiency is inversely proportional to the age of the child (the severity is greater the younger the patient is). «Exposure to the virus causes necrosis of the respiratory tract, followed by an increase in mucous secretion which can obstruct the smallest bronchi in the phase of air leaving the lungs, creating a risk of low oxygen in the blood or causing a breath which can hinder the baby’s breastfeeding», observes Rigante. Once contracted, the respiratory syncytial virus is eliminated for variable periods of 7-10 days and in most cases the infection heals spontaneously. “The therapy of complicated cases may instead require oxygen, fluid therapy and intensive respiratory assistance”. Hence the exceptional load on the assistance system reserved specifically for the little ones, at a particular moment.