Syncytial virus: why mandatory mask-wearing is useful (and other tips to avoid contagion)

The death of several minors due to the syncytial virus, in addition to the high occupation of pediatric hospital beds, generated a real crisis. A few days agoYo As stated by the Undersecretary of Public Health, Andrea Albagli that there were six children under the age of one who died of causes associated with syncytial virus. And recently, on Wednesday 14, a new death was added: a three-year-old girl in the municipality of Monte Patria, region of Coquimbo. Although the exact causes that caused his death have not yet been clarified, it is known that he arrived at the hospital with a respiratory condition. The medical staff tried to stabilize her, but they couldn’t.

Seasonal respiratory viruses tend to attack children and the elderly more strongly in the fall, as these are the age groups most vulnerable to these infections. This happens every year, but it has been more intense, which is why the health authority recently decreed the mandatory use of a mask in schools for all students over the age of 5.

The respiratory syncytial virus, according to the explanations of the Ministry of Health, is one of the main causes of infection acute lower respiratory tract in infants and children worldwide. It also has a significant burden of morbidity and mortality. After infection, the symptoms appear within 4 to 6 days later and result in a runny nose, decreased appetite (in children and infants), coughing, sneezing, fever, and wheezing. In very small babies, irritability, less activity and breathing difficulties can be observed.

Syncytial is a highly transmissible virus and spread by droplets of saliva symptomatic people, and can persist for up to 15 days in the respiratory tract. For parents and guardians of girls and boys, it is important to recognize when dealing with this more complex virus, unlike a cold, precisely because of the consequences it may involve in the population at risk: children , adults over 65, chronically ill and pregnant.

“They may progress worse, have pneumonia or severe respiratory symptoms. For this reason, in case of flu or coronavirus, it is important that they get vaccinated, because the complications decrease, ”explains Javiera Kreft, bronchopulmonary specialist for children and adolescents at Clínica Santa María.

“More than 90% of children, up to the age of two, have already had at least one respiratory or syncytial virus infection,” explains Bárbara Walker, child bronchopulmonary specialist at Clínica Alemana. She points out that “one of the main causes of hospitalization in children under six months is acute bronchiolitis”.

Syncytial is not the only virus circulating. These are also periods of influenza, adenovirus, rotavirus, coronavirus and colds, the latter, in general, without serious complications. Here are the biggest differences between them:

• Common cold: its main symptoms include sneezing, an occasional cough, a runny and stuffy nose, and possibly a fever for a few days. “You have to manage the high temperature and discomfort with flu medication. In addition, it is advisable to maintain good hydration, not to overdress, to keep the patient comfortable and, if there is not so much appetite, to give light and fresh food. », Comments Daniel Gambarrotti, pediatrician Clínica Dávila Vespucio.
• Flu: It is an acute respiratory condition that can trigger mild or severe symptoms, such as pneumonia. On very few occasions it can be fatal. Symptoms that may occur include fever, chest discomfort, cough, muscle pain, headache, fatigue and weakness. “The warning signs of the flu are different from those of a cold. In general, the flu is worse, with more intense symptoms but which, at the beginning of the disease, can be confused”, he warns. Roberto Olivares, head of infectious diseases at Clínica Dávila.
• syncytial virus: it also has symptoms similar to a cold, as it includes nasal congestion, dry cough, low fever, and sore throat. However, according to Leonila Ferreira, head of the Critical Patients Unit of Clínica Biobío, “in some cases it can spread to the lower respiratory system, causing pneumonia or bronchiolitis – inflammation of the airways that enter the lungs -, producing high fever, intense cough, rapid breathing or difficulty in breathing, with a hissing sound on exhalation”.

But the symptoms are not the only common point of these images of respiratory diseases: the way in which they are contaminated is also the same, through saliva droplets that are usually transmitted by sneezing, talking nearby, or through contaminated hands.

Yes, at least this is clarified by the government, declaring it as a strategy and announcing its compulsory use in schools until the end of the health alert, which is currently August 31.

“By using a mask, we cut the chain of transmission,” says Gema Pérez, child broncho-pulmonary specialist at Clínica Dávila. “We are advised to wear a mask in the busiest places that are closed, whether we are on vacation or not, in the event of an outbreak of any respiratory virus.”

“Covid-19 has left us with many lessons. One of them is the proper use of the mask, good hygiene and good hand washing, and the use of hydroalcoholic gel, all measures capable of cutting viral transmission and avoiding contagion. It seems to me a very good measure to use masks again when children must continue to attend school or kindergartens, ”said Walker.

However, several parents have spoken out against this measure on social networks. One of videos The one that causes the most controversy is that of the doctor Guillermo Guevara, who, in addition to declaring that it is a “terrible measure”, affirms that it is an epidemic produced because “since “there was no viral circulation during the pandemic, immunity was not generated in the population. This means that pregnant women did not transmit enough antibodies to their children.

In any case, the measure is mandatory and could ultimately lower the rate of infections.

“ The children most vulnerable to serious and even fatal infections are those with underlying conditions such as congenital heart disease, children with Down syndrome or extremely premature babies,” says Walker. Thanks to the Ricarte Soto law, there is a program for the administration of antibodies against the respiratory syncytial virus in premature babies under 31 weeks or under 1,500 grams, which protects them during the winter months from May to September of each year.

Although the syncytial virus does not currently have an active vaccine, “there is a Pfizer phase 3 vaccine that would be applied to pregnant women to protect, through the transfer of antibodies across the placenta and through breast milk, infants from zero to six months”. , says Perez. Vaccines against covid-19 and influenza “should decrease the likelihood of co-infections of the syncytial with covid or influenza, which would make the picture more severe”, he specifies. His suggestion is to review vaccination schedules and, if they are not up to date—and if they are in good health—parents and children get vaccinated (the latter free up to grade 5).

“The respiratory syncytial virus vaccine has been approved for adults in the United States, but studies are still lacking to support its application in young children,” says Walker. Regarding the massive effect of vaccination, he explains that “it affects the reduction in the number of sick children, probably the number of children hospitalized, and therefore we would have less breakdown of the system and we could concentrate on pathologies such as the syncytial virus, which has no vaccine and whose prevention is the only way to stop its contagion”.

This criterion applies both to going to the nursery, kindergarten or school, as well as for other social occasions such as sports activities, birthdays or events in closed places. “Parents can do a lot to help reduce contagion, and that’s by not sending underage children with respiratory symptoms in school or kindergarten. In this way, we can cut off the transmission of the virus a little ”, assures the specialist from Clínica Alemana.

In Walker’s medical opinion, it is best “to encourage the suspension or postponement of children’s parties until a time when viral transmission has subsided, as children’s birthdays are a risk factor for catching viruses. “.

Winter holidays are synonymous with children, free time, crowds and games. At first glance, this is not seen as a good scenario for mothers and fathers who fear contagion. “They are increasing the offer of recreational activities, such as movies in the cinema or birthday parties in closed areas. There, I recommend considering the use of a mask, especially if they are going to be in contact with more people. ‘kids and with little air circulation,’ advises Walker.

During the covid-19 health emergency, we learned almost religiously that wearing a mask, washing hands and social distancing was the way to deal with the virus. With the syncytial this strategy works in the same way, since as we explained previously, it is a virus that is transmitted in the form of small flying droplets. “If we reduce contact, social distancing, frequent hand washing between people, between caregivers, between parents or between educators, we reduce this contagiousness. If you wear a mask, there is no vaccine in this case for the syncytial virus, but for the other viruses there is, which is why this subject must be associated. The same as ventilation,” adds Pérez.

In the event that your child attends kindergarten, school or a crèche, and given the context of the respiratory virus, it is positive that a cleaning strategy be applied as soon as he arrives at home. “You should change your clothes completely, wash your face, forearms and hands thoroughly to reduce the viral load of viruses that attach to skin and clothing,” Walker suggests. These measures should be followed by anyone living in the house when leaving, especially if they have nursing or elderly members, as they are most vulnerable to infection.