The pediatricians dreaded her, and she arrived a few weeks early. The bronchiolitis epidemic is spreading in all regions with an already critical situation in Ile-de-France and in the Grand-Est, where the intensive care units are already full. According to the latest surveillance bulletin from Public Health France, this respiratory syncytial virus (RSV) infection has led to emergency rooms for nearly 1,800 children throughout France, and a little more than one in three had to be hospitalized. “A start so early in the year is a first”, notes François Angoulvant, pediatrician at Robert-Debré hospital in Paris.
Protected by barrier gestures and social distancing measures, many French children, as well as their parents, have escaped winter infections over the past two years. On the flip side, their immune system is less trained, which would partly explain the surge in respiratory infections since the start of the school year. “The current situation is unheard of. Children aged 12 to 18 months have encountered very little virus so far and are at risk of getting sick, while infants born this year will have more severe forms ”, explains Christèle Gras-Le Guen, president of the French Pediatric Society.
This “Immune debt”, mentioned in particular by the scientific council in its opinion of October 5, raises fears of an epidemic of bronchiolitis more important than in the past, but insofar as there is no precedent, the forecasts turn out to be hazardous. “It’s a bit like making Nostradamus”, emphasizes François Angoulvant, explaining that you have to prepare for different scenarios.
Pediatric emergency and resuscitation services are used to dealing with these epidemic peaks, with expanded teams from November, but the virus took them by surprise this year. The great fatigue of some of the caregivers after four waves of Covid-19 does not help either. “The positions are open, but we cannot find nurses”, testifies the pediatrician, according to whom “The situation could become very, very complicated” if the epidemic peak of 2021 reached the same height as that of 2019. That year, for lack of places in Parisian hospitals, children had to be transferred to the provinces.
Even the “classic” hospital beds are counted: for a year, the pediatric services have been in great demand for psychiatric emergencies, in particular suicide attempts or suicidal thoughts, which require support for several weeks. “The majority of these children and adolescents arrive through emergencies and are hospitalized in general pediatrics”, indicates François Angoulvant, recalling how many child psychiatry beds are counted in France.
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