Bronchiolitis puts Swiss hospitals under strain – rts.ch

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Bronchiolitis puts Swiss hospitals under strain - rts.ch

In France, this respiratory infection of the small bronchi which affects young children overwhelms the healthcare environment. In Switzerland, too, the epidemic has begun. The wave looks bigger and arrived earlier than usual. It comes at a time when pediatric services are already at the limit.

A wheezing cough and a fever that won’t go down. These are the symptoms that alerted the parents of little Eliott, 10 months. The pediatrician diagnoses bronchiolitis, but despite the treatments, the fever remains. Eliott eats little and stays awake little. His parents take him to the emergency room. Faced with the oxygen saturation which remained low despite the Ventolin, the decision was made to hospitalize him to administer oxygen.

“The pediatrician was reassuring,” explains Marie, her mother. “She explained to us that it happened often. But I didn’t imagine that the oxygen was the little tubes in the nose. It was impressive, you have the impression that it’s very serious. Afterwards, we get used to it.”

For lack of available bed, Eliott is hospitalized in the pediatric surgery unit for two days. He will remain in the hospital for a total of 10 days, while the oxygen level in the blood stabilizes. Today he is in great shape.

>> Listen also in the 12:30 pm the details of Alexandra Richard on the prevention against bronchiolitis:

Switzerland is facing a major bronchiolitis epidemic / Le 12h30 / 1 min. / yesterday at 12:34

Very young patients

Testimonies like that of Eliott are frequent in Switzerland at the moment. However, it is difficult to have an overview on a national scale, because bronchiolitis is not a disease monitored by the FOPH. Contacted by the RTS, the hospitals in Romandie testify to an epidemic which does not resemble those of recent years.

“We have always had bronchiolitis this season, but so many hospitalizations at the same time, it is not frequent”, describes Juan Llor, head of the pediatric department at Sion hospital. “Right now, we routinely have one-third of hospitalized pediatric patients who are children with respiratory syncytial virus bronchiolitis.”

He adds that several children are severely symptomatic and require respiratory assistance in the form of non-invasive ventilation, or even a transfer to intensive care. Same observation at the CHUV, where half of the patients hospitalized for bronchiolitis are in intermediate or intensive care.

The head of the pediatric department of the Vaud hospital François Angoulvant notes another novelty concerning the age of the patients: “We have a lot of very young infants, newborns less than a month old. This means that the children have been infected by a member of their family or very close people. He therefore advises to limit visits for children under three months as much as possible.

>> The 7:30 p.m. report:

A wave of bronchiolitis puts pediatric services in French-speaking Switzerland under strain. / 7:30 p.m. / 2 mins. / yesterday at 7:30 p.m.

early wave

Another observation: the bronchiolitis arrived earlier. Usually, the epidemic takes place mainly in December in French-speaking Switzerland. This year, the number of cases has been increasing rapidly for a few weeks already.

Several hypotheses try to explain this new seasonality. The most heard is that of “immune debt”: we would have been less exposed to viruses because of the barrier measures against Covid. Our immune system could therefore have prepared its defense less. This theory, however, is controversial. Several immunologists point out that it is not based on any scientific evidence.

Another track: the Covid would have scrambled our immune system. After being infected with the coronavirus, we would be immunocompromised, making it easier for an infectious disease to develop.

Let us add that bronchiolitis can be caused by several viruses. The most common is respiratory syncytial virus (RSV), but Covid and influenza can also cause the disease.

An additional burden for hospitals

The current bronchiolitis epidemic is putting pressure on hospitals. At present, only the Jura Hospital seems to be spared in French-speaking Switzerland. The other establishments recognize that the situation is tense, in particular because the pediatric services were already at their limits due to the lack of staff and beds.

“In addition, bronchiolitis leads to a relatively long hospitalization this year”, explains Juan Llor of the Sion hospital. “It’s around five to seven days, even ten. Previously, it was settled in three days. This may be the effect of the age of the hospitalized children.”

To cope, hospitals sometimes have to ask caregivers to work overtime or resort to external workers. “While accepting that society tolerates medical executives working up to 60 hours a week,” laments Bernard Laubscher, chief physician of the pediatrics department of the Neuchâtel hospital network.

The hospitals contacted are reassuring all the same: they know how to work under pressure and adapt. As in Eliott’s case, beds are sometimes found in other pediatric units. Pediatric services coordinate between the cantons to organize transfers as needed. If necessary, scheduled operations are paused.

Anouk Pernet

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