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Interview

Flu, gastro-enteritis, bronchiolitis… How to protect children from winter viruses?

stephanie-de-smet
Doctor Stéphanie De Smet - © Communication Department

Monaco paediatrician Doctor De Smet has some advice.

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Every year, the winter period brings its share of infections, particularly among infants and young children. Which are the most common illnesses? How to guard against them? When should we be concerned?

Doctor Stéphanie De Smet, the only paediatrician in private practice in Monaco, answered our questions.

1. Which are the most widespread viruses this winter?

This winter, Dr De Smet has observed a sharp rise in three viruses in particular among her young patients. Starting with the flu : “flu diagnoses have been fairly high every day since the end of the year. It’s a disease with which we’re all familiar, and it affects everyone, particularly small children.”

Extremely contagious, flu generally causes a high fever that can last from four to eight days. Children with flu will recover on their own with no treatment. However, a small percentage of flu cases can have complications, caused by secondary bacterial infections,” warns the paediatrician. As with any viral disease, and as we saw with the Covid-19 epidemic, there can also be severe forms of influenza, particularly in people at risk, such as children with pre-existing conditions and vulnerabilities, especially on the respiratory side. These would be children who were born prematurely, or with malformations or respiratory diseases such as cystic fibrosis. These children are much more likely than others to develop complications from flu.”

Another frequent reason for patient consultations is gastroenteritis. It is a viral infection of the digestive tract leads to vomiting or diarrhoea. It’s a completely harmless disease in most cases. But it can also lead to severe dehydration in the most vulnerable children, such as toddlers and those with immune system issues. In extreme cases, dehydration may require hospital treatment, to rehydrate the child intravenously if it isn’t possible to do so orally,”  explains Dr De Smet.

Finally, bronchiolitis completes the threesome of winter epidemics, although the paediatrician has noted a slight decrease in cases over the last few weeks. As a reminder, bronchiolitis generally starts with a common cold (blocked or runny nose) and a slight cough. The cough then becomes more frequent and breathing may become wheezy. In some cases, the child may have difficulty breathing, run a fever or have difficulty eating and sleeping.

“These three diseases are highly contagious: they spread very quickly in communities, particularly in nurseries,”  explains Dr De Smet.

2. How to protect your child and others?

For Dr De Smet, there is a one-word solution to containing the spread of these three viruses: vaccination. It’s the first port of call in terms of prevention, and we’re lucky to have these vaccinations,” she says. All these diseases can be prevented by vaccination today.”

The flu vaccine is particularly recommended, especially for the most vulnerable children. Similarly, the bronchiolitis vaccination has recently been made available to newborn babies in maternity wards. “This vaccine has already proved its effectiveness, and I personally have seen far fewer cases of severe bronchiolitis in my practice,”  says Dr De Smet.

A vaccine also exists against certain forms of gastroenteritis, and can be administered to infants. “This vaccine will protect against a small percentage of the viruses that cause gastroenteritis, but that small percentage includes the most severe gastroenteritis variants,”  she says.

And while the paediatrician believes vaccination to be the most important measure, we mustn’t forget all the protective measures we can take to avoid infecting others, or being infected ourselves. Like the barrier measures that were recommended for Covid, the medical profession recommends avoiding close contact with others, wearing a mask when you are ill to protect those around you and, of course, washing your hands thoroughly and frequently.

3. What are the warning signs?

Of course prevention is one aspect, but monitoring is also important. A few tell-tale signs should prompt parents to consult a paediatrician or their GP as soon as possible.

“It is important to monitor children’s breathing,” explains Dr De Smet. “A child who has difficulty breathing, or whose breathing is loud, should be checked out by a doctor. In the case of gastroenteritis, the child’s hydration levels should be monitored. This means checking that they are still urinating regularly, but also that their energy levels are normal and that they stay cheerful…”

And if the treatment administered by the doctor does not improve matters, don’t hesitate to call a health professional, or even go to the emergency department. “Parents should be concerned if the child has difficulty breathing, is less cheerful, is wheezy, or struggles and moves around a lot in order to catch its breath. In the case of gastroenteritis, you should be concerned if you are unable to get your child to drink, and if he or she vomits repeatedly. We should also be mindful of their state of consciousness: a child who is not totally conscious, who is drowsy, who is not responding well… all of these things should set alarm bells ringing!”


Informations and useful numbers:

  • Fire service: 18 or +377 93 30 19 45
  • European emergency number(from a mobile phone) : 112
  • On-call doctors and pharmacies: 116 / 117
  • CHPG pediatric department: +377 97 98 95 55
  • CHPG emergency department: +377 97 98 97 69
  • The paediatric emergency department is open 24 hours a day (bring your child’s ‘carnet de santé’ (medical records), their ID and your own)