Children’s clinics: how dangerous is the RS virus for children?

Status: 02.11.2021 2:20 p.m.

It is not a new virus, but many children’s clinics are currently pushing it to the limit. Why the RS virus is particularly widespread this year, how to protect yourself from it – and how dangerous it is.

In addition to Corona, another virus has been dominating the discussions for a few weeks now. The RS virus, which mainly affects children, is spreading very widely across Germany. It is not new to medical professionals. It is one of the common colds that occur every fall and winter. But this year the wave of disease started much earlier, it is stronger than in the past and leads to more complications.

What is RS virus and how is it transmitted?

RS virus stands for Respiratory Syncytial Virus. It primarily affects the airways, causing a runny nose, fever, cough, and wheezing. It can also affect the bronchi and lungs. The infection usually takes place via droplet infection. When sick people sneeze, cough, blow their nose or speak loudly, small droplets get into the air, which are then inhaled by others.

The virus also persists on surfaces. If you reach into it and then put your hand in your face, you can also get infected this way. In addition, the virus can be transmitted if an infected person is touched.

Who gets sick and how often?

In principle, anyone can become infected, but the majority of those infected are children. Small children in particular are infected.

Pediatricians say that by the age of four at the latest, almost every child has had at least one infection with RS viruses. There is no immunity after illness. Once infected, you can get sick again, but then less severely. Therefore, an infection with RS viruses in older children and adults is usually mild.

How dangerous is the RS virus and for whom?

Most people get sick easily and develop the typical cold symptoms. The vast majority of smaller children survive an infection without any major problems. The RS virus can be dangerous for children with poor immune protection, for premature babies, infants and children with previous illnesses, such as a heart defect. There may be shortness of breath and a lack of oxygen in the blood.

If the body doesn’t fight the virus effectively, it can damage the bronchi and lungs. A small number of those affected suffer permanent damage, and in very rare cases children die from the infection.

How can I protect my child from infection?

Avoiding the virus is almost impossible. Children usually don’t keep their distance and RS is very easily transferable. Since RS is a virus, antibiotics won’t help either. Only for risk groups such as sick premature babies is there a vaccination with a drug that does not prevent infection, but prevents a severe course.

Vaccination is extremely expensive, so it is not used more often. Pediatricians like Jakob Maske, the spokesman for the professional association of paediatricians, also advise against avoiding infection in any case. Most children have nothing serious to fear. For them, infections in early childhood are like training the immune system and prevent serious illnesses later, and could also protect against allergies.

Why is RS occurring so frequently right now?

The RS virus, like all other colds that are transmitted by viruses such as influenza or rhinoviruses, needs close contact with infected people. Last year, this contact was almost completely absent. Because of the corona pandemic, daycare centers and schools were closed for a long time. Private meetings also took place less often. In addition, most of the people followed the AHA rules and wore a mask.

The result: There were almost no colds at all. This year these close contacts are back so that the viruses can be transmitted again. So there are two cohorts of infants and toddlers who encounter the virus for the first time. This increases the number of complicated processes as well as the fact that the immune systems of the other children were unable to gain experience in fighting the pathogen in the past year.

What is the situation like in the children’s clinics?

Usually children up to four years of age come to the hospital. That has been the case for the past few years. However, the RS virus season in 2021 began much earlier than in previous years and is more intense – probably due to the catch-up effect due to Corona. That is why almost all children’s clinics are much more crowded than they are usually in autumn. More and more clinics are already reaching their limits. For example, the children’s ward in the Evangelical Hospital Ludwigsfelde near Berlin has to accept small patients from the nearby capital because some of the children’s wards there are already full.

Head physician Georg Reinholz warns, however, that the capacities of his department are almost exhausted. There is a risk that sick people will soon have to be turned away. As in Berlin and Brandenburg it is in most federal states, the situation is tense, but currently still to be mastered. Philipp Stock, chief physician at the Altona Children’s Clinic, says: “Nobody has to worry that children would not be looked after. But bed capacities are tight and no children’s clinic can guarantee that children can be admitted on the spot.”

Why is the occupancy rate of the children’s clinics being discussed right now?

The cold season has also filled the children’s wards in recent years. But this year a number of factors come together that make doctors like Reinholz in Ludwigsfelde, Stock in Hamburg or their colleague Beatrix Schmidt from Berlin’s Sankt Joseph Hospital look worried into the future. The clinics and children’s wards are already well utilized, but the cold season has only just begun. It is expected that the number of hospital admissions will increase. In addition to RSV, there are many other diagnoses that require hospital treatment. The intensive care units in the houses are already worried about Corona.

In the eyes of doctors, however, the biggest problem is the lack of nursing staff. Corona only exacerbated the problem, says Schmidt. There are too few nurses with a qualification for children’s wards. In addition, there have been lower nursing staff limits for the occupancy of children’s wards and children’s intensive care units since February.

That is actually a good thing to ensure the quality of care, but in the current situation it mainly means that fewer beds are available, although demand is growing. Politicians must act here and allow exceptions to the rigid personnel limits at short notice.

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