Bronchiolitis: symptoms, treatment … All about this disease which worries the scientific council

The Scientific Council dedicated to the Covid-19 crisis warned, in an opinion of October 5, 2021, that “the bronchiolitis epidemic could be of great magnitude given a significant acquired herd immunity deficit for children born after March 2020 ”.

Barrier measures related to Covid, confinement, travel restrictions … “the circulation of RSV, responsible for infant bronchiolitis, has been practically zero since March 2020”, recall the scientists. The favorable epidemiological situation of SARS-CoV-2, the lifting of restrictions on international transport, and the reduction in the use of barrier measures will allow the reappearance of this virus in France.

As a reminder, bronchiolitis is the main cause of children’s hospital admissions during the winter. It occurs in the form of epidemics frequently in infants from 2 to 8 months. Each year in France, nearly 500,000 infants under the age of two are affected.

How do babies get it?

Bronchiolitis is caused by a virus. It is spread through saliva, sneezes, coughs, or hands. “A nasopharyngitis of the child or the adult can be at the origin of a bronchiolitis in an infant present in the entourage”, Health Insurance reports. Common in babies under 6 months, the disease causes inflammation of the walls of the bronchioles. Concretely, this results in a serious infection of the lower respiratory tract in the child.

The unmistakable symptoms

A cold or a rise in fever are most often the first signs of bronchiolitis. Quickly occurs a cough initially dry followed by difficulty in breathing resulting in wheezing, difficult and / or rapid. On inspiration, there are signs of intercostal retraction. It is sometimes common to observe difficulty in eating.

How to treat her?

Bronchiolitis may be a mild illness, but it shouldn’t be taken lightly. The priority is to make the child drink more often and in small quantities, to reduce the temperature of the room while humidifying it. After taking care to seek medical advice, you can also administer paracetamol supposed to bring down the fever. Sometimes doctors can prescribe treatment based on washing the nose and aspiration of nasal secretions. In younger infants, bronchiolitis may require hospitalization. The symptoms subside in a few days and the child recovers in 8 to 10 days, but a residual cough may persist for a fortnight before disappearing.

Respiratory physiotherapy called into question

Respiratory physiotherapy is no longer recommended in the treatment of bronchiolitis in children under 12 months by the High Authority for Health since November 2019. “The current analysis of the literature does not show a beneficial effect”, justifies she does. Several studies have shown that respiratory physiotherapy does not reduce the hospitalization time of infants with bronchiolitis. And to recall that “this method of care has only developed in liberal practice mainly in Belgium and France, which makes international comparison difficult”.

For the unions of physiotherapists, their support “goes much further than simple bronchial drainage”. “The physiotherapist examines, assesses and redirects the baby to the emergency room or the attending physician as needed. He reassures and supports parents. It is a key player in health education, ”they recalled in a press release. Without forgetting that “the establishment of networks of physiotherapists in the 2000s has significantly reduced the use of emergencies”.

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