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RESPIRATORY INFECTIONS IN INFANTS & YOUNG CHILDREN

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RESPIRATORY INFECTIONS IN INFANTS & YOUNG CHILDREN

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

The cold weather heralds the start of “flu season,” the hold-all name for a range of respiratory illnesses from the common cold to potentially dangerous viruses like influenza (flu) and Covid-19. In South Africa, flu season usually lasts from May to September.

It’s a particularly worrying time for parents of young children. Infants and young children are prone to respiratory infections for both physiological and social reasons.  Because their immune systems are not yet fully developed, they are vulnerable to germs. The immunity they inherit from their mother diminishes within months after birth. They then need to start developing their own immunological protection, either naturally through infection or artificially through vaccination. Children with HIV and other immunity-compromising illnesses are most at risk.

Social factors, like day care, passive smoking and personal hygiene, also increase children’s risk of infection. Colder weather means they spend less time outdoors and more time indoors in close proximity to other children, making childcare environments particularly high risk. Their exploration of the world involves touching many objects, and their hands invariably find their way to their mouths, so they are constantly exposed to germs.

The burden of flu is high in South Africa, and it is normal for young children to have multiple respiratory infections every year, which can last up to two weeks each time. In most instances, rest, hydration and over-the-counter medications are enough to help your child feel better until the virus passes.

However, as children under 5 years are more likely to develop complications with respiratory infections, they account for a high proportion of hospital admissions. In South Africa, pneumonia and influenza together make up the second leading cause of death in children under 5 years. Taking precautions to reduce the risk to your child is therefore vitally important.

PREVENTING RESPIRATORY INFECTIONS IN YOUNG CHILDREN

You can take steps to prevent common respiratory infections, as well as prevent complications from developing when infections occur.  Interventions fall into four broad categories: vaccination, early diagnosis and treatment of illness, improvement in nutrition, and safer environments.

Respiratory viruses are spread through droplets. When an infected person coughs or sneezes, droplets containing the viruses are released into the air. The viruses also get onto your hands or the tissue when you blow your nose. When people then come into direct contact with each other, for instance by shaking hands or hugging, the virus is more likely to spread. 

These viruses can also be passed to objects. They are easily spread from person to person wherever a lot of people touch the same objects, like door handles or toys. 

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RESPIRATORY INFECTIONS COMMON IN SOUTH AFRICA AT THE MOMENT

The South African National Institute for Communicable Diseases (NICD) keeps a close eye in respiratory pathogens and issues a weekly surveillance report on the more dangerous viruses detected in the population. According to the NICD, at the moment we are experiencing an increase in influenza (flu), Covid-19 and RSV infections.

INFLUENZA IN YOUNG CHILDREN

Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. It can cause mild to severe illness and can be fatal. The best way to prevent flu is by getting a flu vaccine each year.

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COVID-19 IN YOUNG CHILDREN

Covid-19 is the disease caused by the SARS-CoV-2 coronavirus. It is most commonly spread through the air in tiny droplets of fluid between people in close contact. Many people with Covid-19 have no symptoms or mild illness, although over a quarter of a million South Africans have died from it. Covid-19 is usually milder in children, although some children have become severely ill from it.

Risk factors for severe Covid-19 in children include age (younger than 2 years), children who were born prematurely, and children living with obesity or chronic lung disease.

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RSV IN YOUNG CHILDREN

Respiratory syncytial virus (RSV) causes infections of the lungs and respiratory tract. It’s so common that about 90% of children have been infected with the virus by age 2.

RSV can be dangerous for babies and younger children, especially those born prematurely. Respiratory infections are the leading cause of hospital admissions for South African children, accounting for almost 50% of admissions. RSV accounts for 30% of those. The highest hospitalisation rate is from 0-6 months.

The best way to prevent RSV infection is hand washing and paying attention to hygiene. The RSV vaccine is not routinely provided in South Africa. It is very expensive and is used only for high-risk cases like premature babies.

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FURTHER READING