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Viral Diseases in Children Are Discharged After Back to School


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Respiratory viral diseases in children were discharged in the country in the last two months. The reappearance of popular viruses coincides with the period in which there was an increase in students attending in-person classes.

A bulletin from Fiocruz (Oswaldo Cruz Foundation) released last Thursday (28) warned of the reappearance of other viruses, which have caused SRAG (Severe Acute Respiratory Syndrome) in children aged 0-9. The record of these other viruses, which had dropped last year, now exceeds Covid’s number of cases.

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Experts estimate that the return of circulation of these diseases, which commonly affect children, was expected with the return to face-to-face activities. They point out that the population of this age group was protected last year, with the closing of schools, and may now have less “immunological memory”.

Although the increase is expected, the reappearance of these viruses shows the importance of maintaining and reinforcing sanitary safety protocols, such as the use of masks and well-ventilated environments.

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According to the document from Fiocruz, children up to nine years old are being more hospitalized for cases of RSV (Respiratory Syncytial Virus) and renovirus, which had practically disappeared from the monitoring panels last year with the isolation rules.

There was also an increase in positive cases for bocavirus, parainfluenza 3 and parainfluenza 4 in this age group.

These viruses started to grow again at the end of last year and beginning of 2021, exactly the period when some states allowed the reopening of schools. The increase intensified from August onwards, with the greater participation of the return to in-person classes in the country.

“These are viruses that we annually observe as an important cause of hospitalization in children, but which practically disappeared last year and are now reappearing with the greatest exposure of this group with the return to in-person classes”, says Marcelo Gomes, InfoGripe coordinator and researcher at Fiocruz.

According to the InfoGripe bulletin, the incidence of SRAG is stable among children, but with an average still considered high, from 1,000 to 1,200 weekly cases — an index similar to that of June 2020. Data on illness among those aged 0-9 years they go against those of the older age groups, where the occurrence of the syndrome is now the lowest since the beginning of the pandemic.

“This opposite movement among children is not at all surprising, as they are more susceptible to complications from these other viruses and not from Covid,” says Gomes.

The analysis of cases among children also indicates that the reappearance of other respiratory viruses is more present in the center-south region of the country, exactly where more students were able to return to in-person classes.

In São Paulo, for example, where most private schools have been working with all students since August, there was an explosion of cases of other viral diseases, such as hand-foot-mouth syndrome, caused by the Coxsackie A16 virus.

The Municipal Health Department recorded this year 173 outbreaks of the syndrome in the city, and the records grew over the months. There were two in June, eight in July, 48 in August, 94 in September and 21 in October.

Last year, with schools closed, the department did not receive any notification of the disease in the city. The number of outbreaks this year is the highest since 2015. Until then, the year with the highest number of notifications was 2018, with ten records.

The record of outbreaks is not compulsory, so the secretariat and experts estimate that the largest number of notifications may have occurred for greater surveillance of society in relation to respiratory diseases with the concern caused by Covid.

“We, as a society, today have a much greater sensitivity in the surveillance and investigation system for diseases. We are much more attentive to the symptoms and diseases caused by the pandemic and, as a result, there may be an increase in the registration of other viruses”, he says Renato Kfouri, pediatrician and president of the immunization department at the SBP (Brazilian Society of Pediatrics).

For experts, there is no reason for panic among parents, just the maintenance of preventive care.

Some schools, however, have received complaints when cases of other illnesses are reported. This is the case of school Tindolele, in São Caetano do Sul, which two weeks ago turned away a whole group of 20 two-year-old children, after four of them were diagnosed with hand-foot-mouth syndrome.

The father of one of the children who got sick says that the school took a long time to drive the whole class away. However, the health surveillance says that the removal is not necessary for everyone, only for those who have symptoms.

“Parents are more concerned, but the protocol is not the same as Covid’s, but that of other viral diseases, such as flu and gastroenteritis. You only exclude those with symptoms,” says Kfouri.

Experts point out that the occurrence of viral infections is inevitable, but the cases can serve as a warning to schools of the need to improve health protocols.

“We know that the protocol in many schools is not adequate, many focus on procedures that we already know are ineffective, such as measuring the temperature at the entrance, and do not pay attention to what is proven to be important: mask and ventilation of the environments. It would be important to look at these issues,” says Gomes.


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