This disease, most of the time not serious for toddlers, can sometimes require hospitalization.
Faced with an epidemic of bronchiolitis of unprecedented virulence for more than ten years, the Minister of Health François Braun announced on Wednesday the triggering of the national plan planned in exceptional health situations in all French hospitals.
“I decided this morning, in addition to everything that was already mobilized, to trigger the ORSAN plan (organization of the response of the health system in exceptional health situations) specific to this epidemic, to further strengthen the means of the ARS ( regional health agencies) and allow the entire hospital to focus on this particularly acute problem today,” he told the Senate.
Before this announcement, the ARS had communicated several activations of white plans (being able to mobilize staff, reorganize services and deprogramming) – for example in Brittany, Auvergne-Rhône-Alpes, or even in New Aquitaine where the white plan level 2 in Gironde had been triggered.
• What is bronchiolitis?
Bronchiolitis is an infection of the small bronchi, most commonly caused by a very common and highly contagious respiratory syncytial virus (RSV). It is observed in children under 2 years of age, a third of whom suffer from it each year, and especially infants under eight months of age.
The epidemic has a strong seasonal upsurge: it generally begins in mid-October and ends at the end of winter with a peak during the month of December.
Before two years, it is estimated that more than 90% of children have had at least one infection due to this virus, without any consequences in the vast majority of cases. However, very young children, especially those under two months of age, may have more severe forms that may require hospitalization, sometimes in critical care.
• How is it transmitted?
Many people carry the virus and are contagious without knowing it because adults and older children who carry the virus usually have no signs or just a cold.
It is easily transmitted by saliva, coughs and sneezes, and can remain on hands and objects (such as toys, pacifiers, comforters).
To protect their children, parents can adopt simple and effective barrier gestures and behaviors: limit visits, wash their hands, regularly wash toys and comforters, wear a mask themselves or ventilate the rooms.
• What are the symptoms ?
Bronchiolitis begins with a simple cold with a stuffy or runny nose and a mild cough. Then the cough is more frequent, the breath may become wheezy. The child may have difficulty breathing and have difficulty eating and sleeping. He sometimes has a fever.
In the majority of cases, bronchiolitis resolves spontaneously after 5 to 10 days, but the cough may persist for 2 to 4 weeks.
• What to do in case of contamination?
If a baby is sick, you have to go to the doctor. The examination of the infant makes it possible to make the diagnosis of bronchiolitis and to assess its severity, underlines the Health Insurance.
Depending on the infant’s age (especially if he is less than 2 months old), his state of health and the severity of the bronchiolitis, the doctor judges the need for possible hospitalization for monitoring.
But in some cases, it is better to call 15 directly: if the child is less than six weeks old, if it is a former premature baby less than three months old, if he already has an illness respiratory or cardiac identified, if he drinks less than half of his bottles at three consecutive meals or vomits systematically, if he sleeps constantly, or on the contrary, cries in an unusual way and cannot fall asleep.
• How to relieve the child?
The doctor generally advises to declutter your nose by doing nose washes. Indeed, the infant under 6 months breathes only through the nose and does not know how to do so through the mouth. For him to drink and eat enough, he must be regularly and frequently offered to drink water, to avoid dehydration; continue to feed him normally by dividing his meals and offering small amounts if he is tired. Vomiting is common during coughing episodes.
Apart from certain situations assessed by the doctor, respiratory physiotherapy is no longer recommended by the High Health Authority since November 2019 during a first episode of bronchiolitis in infants.
Antitussives, expectorants and thinners are contraindicated in children under 2 years old, recalls health insurance. Also, since the infection is viral, antibiotics are useless.
• What are the figures in France?
Public Health France indicates that, for the week of October 31 to November 6, 2022, hospitalizations for bronchiolitis represent 50% of hospitalizations following a visit to the emergency room in children under two years old. In comparison, this percentage was around 40% during the peaks of previous seasons.
Of the 6,891 children under 2 seen in the emergency room for bronchiolitis last week, 92% were under 1 and 2,337 (34%) were hospitalized.
• Are there any vaccines?
The European Union has approved a preventive treatment capable of preventing severe forms of bronchiolitis in all babies, the AstraZeneca and Sanofi groups, which are developing it, announced on Friday. These synthetic antibodies will not be available before the 2023 season.
Following the respective press releases on Friday from Sanofi and Astrazeneca, the European Commission confirmed to BFMTV that it had authorized the Beyfortus treatment on Monday, October 31. A decision that came into force on Thursday, November 3, after acknowledgment of receipt from the company. This treatment is also currently being tested as part of the Harmonie study in France.
The American Pfizer has also just announced positive results for an anti-RSV vaccine, paving the way for future approval.