A significant increase in cases of pneumonia in children is reported by Public Health France, in weekly reports published Wednesday, November 22. The national Oscour information bulletin mentions, for the week of November 13 to 19, a 44% increase in emergency visits for this reason among 0-2 year olds compared to the previous week, and of 23% among 2 -14 years, for a total of 2,136 passages. SOS-Médecins, for its part, mentions a 30% increase in medical procedures among 2-14 year olds, or 641 procedures. Medical activity for pneumonia is therefore approximately twice as high as in the two previous seasons.
How to explain it? First, viral epidemics, such as bronchiolitis and influenza, are correlated each year with increases in bacterial infections that can cause pneumonia. “In the event of a viral infection, the virus will weaken the respiratory mucosa, which then promotes a bacterial infection,” recalls Romain Basmaci, head of the general pediatrics and pediatric emergencies department at Louis-Mourier hospital (Assistance publique-Hôpitaux de Paris, AP-HP) and secretary general of the French Pediatric Society.
Diagnosis difficult to establish
To this classic mechanism, another factor is added this fall: Mycoplasma pneumoniae, a bacteria that doctors had rarely encountered in recent years. “We are seeing its resurgence throughout the Northern Hemisphere,” according to Antoine Flahault, director of the Institute of Global Health in Geneva, who specifies that “the epidemics of Mycoplasma pneumoniae occur every three to seven years without us knowing very well why.
It is difficult to precisely assess the share of responsibility of this pathogen, according to Mr. Basmaci, because the diagnosis is not always easy: it is based on a PCR test, “but it is not because it is detected in the nose that it is responsible for the infection”. In addition, this test is not a routine examination, and it is not carried out in community medicine but only in hospital.
To better understand the scale of the epidemic, “we must screen and alert doctors”according to Gilles Pialoux, head of the infectious and tropical diseases department at Tenon hospital (AP-HP), but also “send the samples to the national reference center to quantify the surge of Mycoplasma pneumoniae and assess its resistance to antibiotics.
This pathogen has long been known to be resistant to amoxicillin, but it is sensitive to macrolide drugs. However, bacterial strains can over time develop mutations that allow them to survive these molecules. This phenomenon of antibiotic resistance is also fueling concerns among the medical community about the surge in pneumonia observed in northern China.
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