The heat and holidays go hand in hand to a repetitive phenomenon in children’s hospitals: waves of presentations in guard rooms due to enteroviruses infections. Dozens of parents reach emergencies daily with the little ones, scared of symptoms such as high fever, vomiting or diarrhea, and doctors should cope with a sudden, difficult to manage.
High fever, symptom of infection with enteroviruses photo archive
The guard rooms in the pediatric hospitals in the capital and in the country are overwhelmed by a wave of hospitalizations.
Over 120 children arrived in a single guard at the Institute for the Protection of the Mother and Child “Alfred Rusescu”, the majority with high fever, vomiting and dehydration. Many of them have been diagnosed with enteroviruses, infections specific to the hot season, which are quickly transmitted by direct contact or contaminated water.
Prof. dr. Mihai Craiu, a pediatric specialist, told, exclusively for Adevărul, how he went on Friday night (August 15-16), when he was on guard.
Of the total of 99 presentations, cases of trauma can be counting on the fingers, he says. The rest, were children with very high fever and two types of disease patterns: digestive – in which the vomiting and chairs dominated; respiratory -Some enteroviruses do respiratory disease, which is the most known being herpagine or hand-pier-grain syndrome.
“It was, somewhat normal to happen, because we are in the middle of summer, in the area of heat and significant circulation of various types of viruses: from the hands, surfaces, water from the pool, the bars of the parks in the parks. (…) Some seems to be the risk is very low. At this moment the risk is not so small“says the pediatrician.
Many cases concentrated in a very short range
The doctor claims that an alarm signal should not be drawn regarding the number of cases. Although they seem more numerous than in the past summer, the specialist says that the phenomenon is just a statistical illusion. “Now there are many cases in a small time and seem to be more. There are no more, they are the same as last year, except they are concentrated in a shorter time. There are no worse children affected than in other years ”, says Mihai Craiu.
However, the pediatrician recognizes that there were severe forms, but they are not a novelty:
“In the last week I also had cases with encephalitis or meningitis. It is certain that, compared to other summer viruses, they also have a profile for the central nervous system and are close relatives of the polio viruses. It was expected to appear neurological phenomena.
Pediatrician: “They came like a tsunami”
The real problem is that, such a “tsunami” of cases came in a very short time and puts a great pressure on hospitals and medical staff. Dr. Mihai Craiu acknowledges that sometimes the medical staff are numerically outdated.
“The impact comes from the fact that hospitals cannot absorb 100 patients with the same type of disease. In the guard, from the hospital in Făgăraș, to the hospitals in Bucharest, there are only 2, 3, 5, 6 doctors. If 100 such children come, the pressure on the medical system is too high, which is not ready to absorb emergencies on holidays. Too many at once came, like a tsunami ”, supports the doctor.
The situation is aggravated in the counties where there are no pediatrician doctors.
“There are areas that do not have a pediatrician on guard, have adult doctor. Example would be the Tulcea County Hospital, which does not have the children of children during the night. I put them on the rescue and send them to Constanța. You cannot send, one night, not 100, no 20 hour from hour. You do not have so many salvations ”,
emphasizes Dr. Craiu.
How the situation is managed: “We do not send home children on the grounds that we have no places. We are looking for solutions”
Since, in a single guard, even over 100 children crossed the threshold of the unit, the medical teams were forced to prioritize severe cases.
“The fighting plan, especially on holidays, is to help, manage as many children as possible in the Emergency Reception Unit. From Saint Mary, all day and all night I had the part of the insulator full of children at infusions or who received high -fever doctors, only the cases where the children did not calm down or where the parents were far, or the extremely small child, with other health problems. Only I was admitted to them ”said Dr. Craiu.
In parallel, there is a close cooperation with other hospitals.
“During the night we spoke about 4-5 times with the guard doctors at the ‘Grigore Alexandrescu’ Hospital in Bucharest, who are in exactly the same situation as we are and have fewer beds for children. They have asked us to accept children for the hospitalization.he continued.
Even when there are no places, children are not sent home without full medical support. The pediatrician explained that the little ones are stabilized in the Emergency Reception Department, where all the relevant investigations are made.
“We do not send children home because we have no places. We are looking for solutions. We keep in touch with the other hospitals. If they come in serious condition, we put them on infusions, we have some isolation areas, even if they are not admitted to the hospital itself. The child receives the proper medication. In other cases and when the child is a little larger, we give them a prescription of rehydration solutions and we make a personalized diet program. We describe some signs of aggravation, and if things take such an adverse turn, then they have to return for hospitalization ”, the doctor told us.
Also, in hospitals, doctors do quick tests to detect the type of enterovirus and to avoid hospitalization with different infections in the same salon. Most are treated with rehydration and symptomatic medication, and serious cases are directed to insulators or other hospitals.
Fortunately, doctors claim that there are rare cases in which complications appear.
Relaxation from holiday and torment after
Doctors put the large number of cases and on account of relaxing hygiene measures during the vacation. The explosion of cases is directly proportional to the number of large cultural events, such as festivals, which have been held lately. Most children, hospitalized in the last few days, had been at the pool.
“In principle, these children with proven enterovirosis, most have fever, nausea, vomiting. In the hot days, the circulation of these viruses is intense. One day, on average, 20-25 children with diarrhea were presented ”stressed the doctor.
The pediatrician also reminded the fact that enterovirosis cannot be treated with antibiotics. Even if there is no specific treatment, prevention is simple: increased attention to hygiene!
“The most handy solution for parents is to help their children or to follow the little ones not to take their hands without wash. If there is no handy bath, then use disinfectant gel, especially at sea or pool ”recommends Prof. Dr. Craiu.
What are enteroviruses and why summer appear
Enteroviruses are a large family of viruses, with over 280 types described, which can cause a variety of diseases – from simple digestive or respiratory infections, to forms that can affect the central nervous system.
They are the distant “cousins” of the polio virus, which explains why, in some cases, neurological symptoms such as meningitis or encephalitis may occur. Usually, however, most children make easy forms, with fever, vomiting, diarrhea or specific eruptions (“hand-grid”).
The most exposed are young children, who have a developing immune system and who frequently come into contact with other children, especially on vacation, play, swimming pools or crowded events.
