Considered the most propitious times for the proliferation of respiratory syncytial virus (RSV)because they are the coldest and driest seasons, in autumn and winter it is more common to observe an increase in children hospitalized with bronchiolitis and pneumonia. In this way, preventive measures and early diagnosis are tools to avoid the worsening of the clinical picture.

Belonging to the Pneumovirus genus, RSV is one of the main agents of acute respiratory tract infection. The virus reaches the bronchi and lungs. There is no vaccination against RSV. Only in the case of premature children born up to 28 weeks of gestation or with a risk factor such as babies with bronchopulmonary dysplasia and congenital heart disease, a program of the Ministry of Health offers palivizumab, a specific antibody against the syncytial virus, applied once a month during five months, before the period of greater circulation of the virus, to avoid serious forms of the disease.

Breastfeeding, for example, is an important immune booster. That is, early weaning makes the child more fragile. In addition, in the case of people who smoke, it is important to prevent the child from being exposed to smoke.

“Respiratory viruses have common symptoms such as cough, fever, sore throat and runny nose. In RSV, what draws attention is the age of the baby – it usually affects children up to 2 years of age more often – and the difficulty in breathing, symptoms associated with the time of year with the predominance of virus circulation. Of course, there are also tests to know which virus affects the child at that moment. Persistent fever and a child who does not respond to stimuli are warning signs. This goes for all diseases. Young children with respiratory conditions need to be evaluated by doctors”, he advises. Renato Kfouripediatrician, infectious disease specialist and president of the Immunization Department of the Brazilian Society of Pediatrics (SBP), during his participation yesterday in the Estadão Think Forum “Bronchiolitis and pneumonia can attack even indoors – keep your warrior from having to fight RSV”, sponsored by AstraZeneca.

In the case of bronchiolitis, children can transmit RSV for more than a week. Even after showing improvement, it is important to pay attention. Marco Aurelius Safadi, professor of pediatrics and infectology at the Faculty of Medical Sciences of Santa Casa de São Paulo and president of the Department of Infectious Diseases of the Brazilian Society of Pediatrics (SBP), points out that in younger children the risk of aggravation is greater. “A child with respiratory distress in this age group who loses the ability to breastfeed has factors taken into account when evaluating the clinical picture. Many cases require hospitalization to provide respiratory assistance for the baby”, says Safadi. “Hydration is essential in this case. And it is worth reinforcing breastfeeding in the case of the baby who breastfeeds and even increasing the supply of formula in the case of babies who do not breastfeed”, says the professor of pediatrics.

Second Rosana Richtmann, an infectious disease physician at the Hospital and Maternity Santa Joana, Pro Matre Paulista and the Instituto de Infectologia Emílio Ribas, premature babies are among the high-risk groups. “The thinner bronchi become swollen and the virus causes secretions, obstructing the airways and the child becomes more tired,” she says.

Safadi adds that other groups are also more vulnerable. “Children who have heart disease, those with chronic respiratory diseases, those who were born with encephalopathy and those who are immunosuppressed are other groups that we try to monitor to avoid greater risks. However, it is worth remembering that in more than 80% of cases hospitalizations and deaths affect healthy low- and middle-income children, mainly due to the fact that they do not have timely access to adequate treatment”, points out the specialist.

According to Kfouri, older children can also be affected, however, the condition is milder. “Older children and adults when they acquire RSV have milder conditions, as they had previous exposure to the disease, unlike babies up to two years old. reinforces the specialist.

Fathers and mothers who faced the disease

In 2017, when he was 40 days old, the eldest son of presenter and entrepreneur Rafa Brites began to suckle and breathe with difficulty. “Rocco was just over a month old when he started choking while breastfeeding. He always suckled well. I started to see that he was breathing with difficulty, showing up to his ribs, at dawn that the RSV test was positive and he was admitted to the neonatal ICU”, he said. also the mother of the three-month-old Leon. For ten days, he remained hospitalized without receiving medication, due to his age, doing only respiratory physiotherapy to improve his clinical condition.

The mother of three, journalist Nanna Pretto from the Dica de Mãe Blog, says that everyone has had bronchiolitis. Gabriel, now 14 years old, was diagnosed with RSV when he was 1 year and 9 months old. “One morning, he woke up with the flu, breathing more difficult, I noticed that there was something strange. We went to the hospital. The saturation was low, at 87, and he had to be hospitalized because of bronchiolitis. He was hospitalized for four days to recover” , reports Nanna, who is also the mother of Rafael, 8 years old, who had her first crisis at two months. “He was diagnosed with bronchiolitis. There were seven diagnoses in the first year of life. He did not need to be hospitalized”, she says.

Luísa, aged one year and five months, had her first crisis at two months. “The saturation dropped and she was sulking and denying food. She had to do x-rays. She didn’t need to be hospitalized. A month ago, she had a new crisis. She was diagnosed with bronchiolitis. And she is under treatment at home”, reports Nanna.

As a way of preventing respiratory diseases, actress and journalist Sabrina Petraglia seeks to maintain preventive hygiene measures and control the vaccination of all family members since she had her first child. Gael, now three years old, was born premature at 34 weeks and even needed to be intubated.

“It’s very sad. We don’t know what will happen. I had to initially breastfeed him with a tube. He spent 19 days in the ICU. With that, I became a neurotic mother with all the care. I also try to maintain hygiene care with my older children. regarding the baby”, says Sabrina, who is also the mother of Maya, who is just under 1.5 years old, and Léo, who is just over a month old.

Francisco Ivanildo de Oliveira Júnior, medical manager of the Hospital Infection Control Service and quality and infectologist at Sabará Hospital Infantil, warns that the hospital, as well as other health networks, has beds full of children with respiratory diseases, not just RSV.

“To avoid contagion, parents should avoid agglomerations so as not to expose young children to the various viruses that exist in the environment, whether respiratory or not. Children with respiratory symptoms, in the last 24 hours, should also remain at home. It is worth consulting the pediatrician about recommendations, either in person or by telemedicine. People who have flu-like symptoms or who have had contact with medical issues in the last 24 hours should also not visit newborns”, advises Oliveira Júnior, who reinforces that, in case of discomfort due to secretion, Parents should also aspirate the secretion to provide relief to the baby and prevent the disease from getting worse. Therefore, it is important for parents to pay close attention to their children’s behavior.

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