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Published on: December 10, 2013
Bronchiolitis in children ≤ 12 months during the pre-flu season of 2024: A case series
Marietjie Brits1, Hanneke Brits
1Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein. 2012038747@ufs4life.ac.za.
Insights
Influenza A, not respiratory syncytial virus (RSV), caused severe bronchiolitis in young children. All patients recovered with standard symptomatic treatment, indicating current guidelines are effective for this unexpected pathogen.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- A warning for a respiratory syncytial virus (RSV) outbreak was issued in March 2024.
- Severe bronchiolitis cases in infants increased at National District Hospital, Bloemfontein, since April 2024.
- Investigated the cause of severe bronchiolitis and treatment guideline efficacy.
Purpose of the Study:
- Identify the causative agent(s) of severe bronchiolitis in children.
- Assess the appropriateness of current treatment guidelines for bronchiolitis in the study setting.
Main Methods:
- Retrospective file review of children admitted with bronchiolitis.
- Study period: 4 weeks.
- Case series design with ethical approval.
Main Results:
- Ten infants (≤ 12 months) presented with moderate to severe bronchiolitis (Modified Tal Score 8-12).
- Influenza A was detected in 60% of cases; RSV in 20%.
- All children responded well to symptomatic treatment and recovered.
Conclusions:
- Influenza A, not RSV, was the primary cause of the severe bronchiolitis outbreak.
- Current symptomatic treatment guidelines were effective for Influenza A-induced bronchiolitis.
Background:
In March 2024, the National Institute for Communicable Diseases (NICD) warned against a respiratory syncytial virus (RSV) outbreak during the pre-flu season, 2024. Globally, RSV is responsible for most respiratory infections in young children. Since April 2024, we have noticed a more severe presentation of children with bronchiolitis at the National District Hospital, Bloemfontein. We aimed to investigate the causative organism/s and the appropriateness of the treatment guidelines in our setting.
Methods:
A retrospective file review was carried out as part of the normal audit process. All children admitted with bronchiolitis during the 4-week study period were included in the case series. Ethical approval was obtained from relevant authorities.
Results:
Ten children ≤ 12 months presented with bronchiolitis symptoms. The Modified Tal Score was measured, with values between 8 and 12, indicating moderate and severe bronchiolitis in all cases. The demographics regarding gender, nutrition and vaccination status did not differ from previous years. Influenza A was identified in 60% of the cases, with RSV in only 20% of the cases. All the children responded well to symptomatic treatment and recovered.
Conclusion:
Most bronchiolitis cases were caused not by the predicted RSV outbreak but by Influenza A.Contribution: Despite presenting with severe symptoms, all the children responded to symptomatic treatment as set out in our guidelines.
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