The Gazette | Flu season among children arrives earlier in ES; know how to avoid illness

There are still around 50 days until winter arrives, but Espírito Santo is already facing an increase in cases of Severe Acute Respiratory Syndrome (SRAG) in children. One of the main causes is the Respiratory Syncytial Virus (RSV), which is responsible, in most cases, for the emergence of acute bronchiolitis. But there was also an increase in flu cases.

In the state network alone, 453 cases of respiratory syndrome caused by RSV were registered until April 20, 403 of which were in the age group 0 to 4 years old, as explained by the State Department of Health (Sesa). To give you an idea, throughout 2023, there were 570 cases. In 2022, there were 509 registrations.

“Sesa points out that the cycle was brought forward in the State, and that the health network has been able to absorb the demand for care from the population”, informs the secretariat, in a note.

A clarification regarding the anticipation of the viral cycle was requested from Sesa on Friday (26). However, the department only informed, this Monday morning (29), that it has no sources available. A supplementary note was then requested, but the secretariat did not comment on this.

The increase in RSV cases in children up to 4 years old is indicated in the latest InfoGripe bulletin, which monitors cases of Severe Acute Respiratory Syndrome (SARS) in the country. The growth of infections is most significant among children up to two years of age. On a smaller scale, there is also an increase in RSV contamination in the age group from 5 years old, where flu cases have also skyrocketed.

“The Department of Health explains that cases of Severe Acute Respiratory Syndrome caused by Respiratory Syncytial Virus (RSV), known as bronchiolitis, are not compulsory to report and, therefore, the numbers of (real) cases may be different (higher) from those recorded. ”, reinforces Sesa, also pointing out that the gateway to care is in Primary Health Care, that is, through the Basic Health Units of the municipalities.

In Vila Velha, for example, the municipal Health Department reported that there was an increase in the number of children with respiratory crises seen in the city’s health units and emergency rooms. “In the last month, 13 cases of children up to 12 years old with Severe Acute Respiratory Syndrome, requiring hospitalization, were reported”, points out the note sent by the secretariat.

The ministry also highlights that the health units in Vila Velha are adequate to comply with the care protocol for the public affected by the disease.

In Serra, there was also an increase in cases, with a predominance of Influenza and respiratory syncytial viruses, based on random weekly samples that are sent to the Central Laboratory of Espírito Santo (Lacen).

“Between epidemiological weeks 13 to 16 (from March 24 to April 20), there was a predominance of respiratory syncytial virus (62%), in the childhood age group (under 7 years old), followed by the Influenza virus (31% ), in all age groups, and, to a lesser extent, the covid-19 virus (7%), in different age groups”, informs the city hall.

Also according to a survey carried out by Atenção Básica da Serra, from January to March 2023, 1,389 consultations were carried out for cases of flu-like symptoms. From January to March 2024, there were 1,700 cases of flu-like symptoms.

In Vitória and Viana, there has been no record, to date, of an increase in care for children with flu-like symptoms in municipal health units, according to the city halls consulted.

Roberta Melotti, a pneumopediatrician at Unimed Vitória, says that, since February, cases of bronchiolitis have increased. She mentions that one of the causes for this may be linked to the period of isolation due to Covid-19, which may have changed the behavior of other viruses, in addition to causing a delay in vaccination.

“Vaccination has left a lot to be desired. We have seen children with less and less complete cards, mothers who are afraid of vaccinating children. In this regard, Covid has hurt us a little too. It seems that there is a fear of everything having an adverse effect and it is a behavior that harms both child protection and collective protection”, observes Roberta.

The pneumopediatrician reinforces that cases of bronchiolitis, specifically, can be fatal for babies and that it is important for parents to pay attention to the warning signs of the disease. “It starts as if it were a common cold: runny nose, cough, maybe a slight fever. But, around the second or third day, it starts to get worse. The child has difficulty breathing, their general condition drops, they don’t want to eat “, details the doctor.

Roberta advises that, in the event of any warning sign, including rapid breathing and the baby’s belly showing when breathing, it is essential to see a doctor to assess whether the child needs to be hospitalized or whether it can be treated at home.

Some care, however, can help prevent diseases, which also affect other age groups. Children’s pulmonologist Lais Fraga highlights, for example, that viruses are common at this time of year and that everyone can be affected. But she remembers that children and the elderly tend to be the most affected.

“The big problem is those children who are very young, sometimes premature, or who have lung or heart problems. RSV is a virus, but it can lead to a respiratory syndrome, which is bronchiolitis. In adults, it usually causes a cold or something similar. But, in children, it can make it difficult to breathe, having to use their lungs a lot. Sometimes you have to be hospitalized. But there are some ways to reduce the risk of contamination”, points out Lais Fraga.

In this sense, she advises that families avoid taking babies to closed or crowded places, such as parties, shopping malls, among others.

The doctor also recommends that families avoid contact with people who show flu-like symptoms or diarrhea. In cases of babies, restrict contact with older school-age children who have frequent contact with other people, as their immune systems are still fragile.

“It’s a common virus. We have greater circulation at this time of year, but it is a common virus. Let’s remember that the vaccine against the syncytial virus will now be released for pregnant women and that vaccinating pregnant women increases the child’s immunity, because it passes from the mother to the newborn”, says the pulmonologist.

“To protect children, the vaccine must be administered to mothers during pregnancy. The vaccine is not administered directly to babies”, emphasizes Anvisa.

Furthermore, the National Flu Vaccination Campaign is already underway and runs until May 31st. In addition to pregnant and postpartum women, children aged 6 months to under 6 years can also be immunized at health centers. Check out the full list of priority groups here.

• Respiratory Syncytial Virus (RSV): it can affect the bronchi and lungs, mainly affecting newborns and children. It is most often responsible for the appearance of bronchiolitis (inflammation of the bronchioles) and pneumonia, especially in premature babies.
• Adenovirus: They preferentially infect cells in the airways and cause diseases such as colds and flu, conjunctivitis, bronchitis, pneumonia and some diseases of the intestinal tract.
• Influenza: virus that causes influenza, a disease that affects the respiratory tract. Easy to transmit, it usually has a quick recovery. Children under 2 years old, however, are among the groups that tend to present more complications, such as pneumonia.

• Persistent symptoms;
• Rapid breathing;
• The baby or child’s belly is marked when breathing;
• The cough becomes more intense;
• The child does not want to eat;
• There is a change in urine production.

Especially during autumn and winter, when respiratory viruses are more common, some precautions must be taken:

• Keep your vaccination card up to date;
• Avoid contact with sick people;
• Keep environments ventilated;
• Always wash your hands;
• Do not put your hand in your mouth or nose without prior hygiene;
• Avoid taking babies or children into closed environments or with crowds of people;
• Restrict contact with people who circulate in these environments;
• Avoid introducing babies to daycare centers before six months during this period;
• Do frequent nasal washes;
• Avoid kissing babies’ faces or hands.

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