A flu season in the temperate zone lasts about 6-9 weeks, so the number of infections is very likely to remain high. After three weeks of accelerated flu growth, we are on epidemiological alert, and the death of a 3-year-old boy hospitalized due to complications from the flu virus has created excitement among parents.
The onslaught of respiratory viruses will continue. Photo: Archive
Pending the completion of the official investigation, which will determine whether or not the tragedy is related to the aggravation of a flu infection, it is necessary to understand what is happening and what needs to be done, draws the attention of associate Dr. Mihai Craiu, primary pediatrician. “What is happening in Romania is also happening in the rest of the northern hemisphere: a massive increase in the number of flu cases, the highest in 10 years”explains the specialist on the Virtual Children’s Hospital page.
What can parents do
This increase is associated with overloaded medical systems and increased hospitalization rates. “Children, especially those under 5, represent the main age group in which a large number of hospitalizations are observed. Old people over 65 are only in second place”, highlights conf.dr. Mihai Craiu.
In addition, this season, the increase in the number of hospitalizations in children – as a result of flu complications – has appeared very rapidly compared to previous years – as early as November 2022 – and has risen to alarming levels in Canada and the United States, but also in the EU and Great Britain. “Unfortunately, dead children have also been found there. In Connecticut, Idaho, Illinois, there have recently been reports of child deaths as a result of complications from the flu”says the specialist.
What parents can do now, adds the doctor, is not panic but look for solutions. Influence is a respiratory infection of the airways that can develop severely and is transmitted through the air. “In other words, you are MUCH more likely to get the flu in a crowded, enclosed space where people are sneezing or coughing. The risk is MUCH less outdoors. We can reduce the risk of illness in other ways than by avoiding crowds – by frequent ventilation – with all our fear that “the draft is out”, classrooms really need to be well ventilated, starting now -, or by using a mask, especially in crowded areas: subway, shop, classroom. Even a makeshift mask or a bandana over the mouth are better options than… nothing.”recommend the university.
In addition, special attention should be paid to hand hygiene, as the flu virus survives on surfaces and can easily enter the nose, mouth or eyes of a child who touches his face with dirty hands after touching doorknobs, handles or railings. “That’s all that can be done now”concludes the pediatrician about the flu.
Bronchiolitis is on the rise worldwide
Another respiratory virus that mainly infects young children is the syncytial virus – RSV. “Acute bronchiolitis is on the rise worldwide and was even before the pandemic,” Prof. Dr. Mihai Craiu draws attention. And the child is not a miniature adult, so while they may have the same signs of the disease, the mechanisms for producing them are different: “In acute RSV-induced bronchiolitis, the cough and wheezing are not produced by the same mechanisms that produce the cough and wheezing in an adult with asthma or an elderly person with COPD – chronic obstructive pulmonary disease”.
The doctor explains how, in an adult in the throes of an asthma attack, Ventolin is applied and it works because at the level of the muscle cells of his bronchi, the drug stimulates type 2 beta-adrenergic receptors (RBA2), stimulation that relaxes the bronchial muscles, disappearing borospasm. While in a young child, these RBA2 receptors, although they exist, are of lower density and are immature, so they can be blocked or partially destroyed.
“Children who develop bronchiolitis with RSV may develop asthma in the future, but NOT BECAUSE they did not receive asthma medications when they had the acute illness, but because the immune mechanisms that the child uses to recover from bronchiolitis favor the activation of some processes with allergic mechanism”emphasizes the pediatrician.
Studies show that the risk of being diagnosed with asthma in adulthood is ten times higher for children hospitalized with RSV bronchiolitiscompared to those with common colds of the nose and throat. “In conclusion, acute RSV bronchiolitis is not mechanistically similar to an asthma attack in an adult and, as such, the use of anti-asthma medications in an infant with moderate or mild bronchiolitis, possibly sent home, does not it is necessary and may have adverse side effects.It is better to prevent RSV bronchiolitis, by non-pharmacological means – hygiene, avoiding gatherings with an infant – or pharmacological – anti-RSV monoclonal antibodies, rather than unreasonably expecting to cure the treated disease with ineffective drugs”, recommend the pediatrician.
Recommendations for students
School lessons resumed on Monday 9 January, under conditions of alert for the flu epidemic announced by the authorities. The Ministry of Education has sent schools information materials designed by the Higher Institute of Public Health and intended for students, parents and teachers. Therefore, the recommendations refer to proper hand hygiene, which includes washing for 20 seconds with soap and water, before and after eating, before and after handling food, after going to the bathroom, after touching animals, playing outdoors, before and after being in the vicinity of a sick person.
“The flu virus, but also other types of viruses, are spread easily in the air we breathe by a simple sneeze or cough. Protect those around you by bringing your elbow to your mouth or by sneezing, coughing into a tissue, then sanitizing your hands “it is also reported in the information materials.
In crowded or unventilated spaces, it is recommended to wear a medical mask. At the same time, your water bottle, corkscrew, lip balm, handkerchief and other personal items are not shared with others, as bacteria and viruses can be transmitted from one person to another through them. If students start feeling sick at school (coughing, sneezing, runny nose, difficulty breathing), they are encouraged to tell their teachers.
COVID-19. Over 50 dead in one week
The number of SARS-CoV-2 infections detected has increased in the past week, to 4,107 – from 12,110 RT-PCR tests performed – from 3,600, the previous week. According to official data, the number of deaths also increases: from 34 in the week from December 26, 2022 to January 1, 2023, to 52 in the period from January 2 to 8, 2023. The 14-day infection rate increases to 0.27 cases per thousand inhabitants, from 0.25 last week.
1,025 people are hospitalized in the COVID-19 wards of hospitals, of which 119 in ATI – 109 unvaccinated.
Jurma: “The epidemic is only now starting in China”
Specialists estimate that in the coming period, SARS-CoV-2 infection numbers could increase again, with the appearance in Romania of the Kraken subvariant (XBB 1.5 by Omicron), the most transmissible of all SARS-CoV-2 variants so far. subvariant that became dominant in the United States. “If we remember what it was like in the first years of the pandemic, we remember that what happened in Western European countries also happened here after about two weeks. So it’s possible that now it will be the same”, is the opinion of prof.dr. Emilian Popovici, vice president of the Romanian Society of Epidemiology.
Researcher Octavian Jurma notes that the year 2023 started with a paradigm shift in health policy, hence a lot of uncertainty on the pandemic front:
“As optimistic as we may be, we cannot deny that the epidemic is only now starting in China. In the most optimistic scenario, 1,500,000 people will repeat the history of the West for the last 3 years. This means that the variants imported from The West will undergo mutations and recombinations in the next 2 years and will be exported back to the West.”
appreciate Jurma. We recall that the number of infections has exploded in China.
According to researcher Octavian Jurma, the flu is not as big a threat as COVID-19: “Over the past three months in Romania, the apparent mortality from COVID-19 was 0.9% and from influenza 0.01%. Thus, COVID-19 remains a much more serious disease than influenza, even with the Omicron variant, despite its labeling as a “common cold” or a “natural vaccine”. The truth is that the flu outbreak in the context of the COVID-19 pandemic is only one aggravating factor of the COVID-19 pandemic that has become , since the end of 2022, a pandemic of “respiratory viruses” where we have different viruses which in turn rapidly produce different variants”.
So far, 3,316,192 cases of SARS-CoV-2 infection have been registered in Romania.
