Earlier, faster and more severe. These are the features of the bronchiolitis epidemic which affects France less than two months after the start of the September school year, according to the table drawn up by health professionals interviewed by franceinfo. “In general, the epidemic peak starts in mid-November and peaks between Christmas and New Year before declining”, explains Doctor Sébastien Kiefer, pneumopediatrician at the regional university hospital (CHRU) of Nancy and at the regional hospital of Metz, in the Grand-Est region.
In mid-October, the period when the epidemic usually begins, the respiratory bronchiolitis virus has already shifted eleven regions of France into the epidemic phase, according to the latest weekly bulletin on this disease from Public Health France, published October 20. The situation of pediatric emergency services, whose attendance is increasing week after week, worries the medical profession.
“The emergency room consultation rate is 30% higher than in other years on the same date”, calculate Sébastien Kiefer. “In terms of emergency room staff, it’s getting complicated, assures the pediatrician. We are really at the limit of adequate care for the patient and his family. ” Same observation in Ile-de-France. For three weeks, activity has increased between “15% and 20%” at the Robert-Debré hospital in Paris, considers the head of the pediatric intensive care unit, Stéphane Dauger.
Nationally, dince the end of September, visits to pediatric emergencies and subsequent hospitalizations have increased by an average of 30% per week, according to Public Health France. During the week of October 11 to 17, more than one in four pediatric hospitalizations was due to bronchiolitis. In addition, of the 799 children hospitalized, 93% were under 1 year of age. A “foreseeable situation” on which alerted the National Professional Council of Pediatrics since April-May.
How to explain the precocity of this wave, which appeared at the end of the summer in certain departments ? The doctor Sébastien Kiefer puts forward the hypothesis of a “weak circulation of the virus last winter” and one “strong return of the circulation of viruses with the deconfinement of April-May” 2021.
Furthermore, “the little ones, aged one or two years, have never known a virus and therefore have a weak immune defense, continues the specialist. This explains their greater vulnerability to respiratory viral infections this fall. ” An analysis shared by the Scientific Council in its last opinion published on the 5th October as well as by Professor Stéphane Dauger, also concerned about the situation.
“We are very concerned for the weeks and months to come, as the increase in the epidemic curve is accelerating more than usual.”
Stéphane Dauger, head of the pediatric intensive care unit at Robert-Debré hospitalto franceinfo
For the head of department, it will be necessary “quickly” react to this premature influx of cases of bronchiolitis. Because this one “adds to the difficulties that have existed for several months” he raises.
“Not only are there other viruses circulating, such as gastroenteritis and the flu, but there are also decompensations in some children, others who suffer from chronic illnesses and who need to be taken care of or monitored. on time “, remarks the professor. He thus dreads to take again “three to four months late” in the care of patients, after “almost two years of shutdown due to Covid-19”. “Unlike an adult, making a child of 18 wait months more than six months for an MRI is too long and can be dangerous for his health “, insists Stéphane Dauger.
For the time being, the pediatric services of the Robert-Debré hospital and the Nancy and Metz hospitals are still absorbing all admissions. But the tension in hospitalization, for lack of sufficient beds at the end of intensive care, is already starting to be felt.
Non-urgent pediatric surgeries have been postponed and the Nancy hospital is considering opening its bronchiolitis unit now, usually set up in November. “For that, we need not only beds, but above all qualified staff. What we lack, specifies Doctor Sébastien Kiefer. The caregivers are tired and this epidemic comes at a time when we weren’t necessarily ready. “
“In thirty years of experience, this is the first time that we find ourselves in this state, at the foot of the wall, alarmed Professor Stéphane Dauger. And unlike in adult emergencies, in pediatrics, we can’t rely on the private sector because it doesn’t exist. “
In the Grand-Est region, as in Paris, pediatric staff hope to avoid prioritizing patients at the onset of winter if the epidemic does not calm down by then. “Although it started early, we hope it ends sooner as well”, predicts Sébastien Kiefer.