Flu and bronchiolitis: finally the end of the tunnel?

Flu and bronchiolitis finally the end of the tunnel

Is the infernal trio losing ground? According to the latest bulletin from Public health France, the circulation of influenza and bronchiolitis, which spread at the same time as that of Covid-19, seems to be slowing down. The flu epidemic has receded in recent days, remaining at a “high level”, while, in infants, that of bronchiolitis continues but with hospitalizations still falling, summarized Wednesday January 4, the agency health. The week of December 26 to January 2 was marked by a “slowdown in the circulation of influenza viruses with a maintenance at a high level”, noted Public Health France in its weekly report.

Good news: last week, “flu indicators were down in city medicine and emergencies”, specifies the national health agency. A trend observed in all age groups, except among those aged 65 and over. Overall, the flu epidemic remains at a high level. All regions remain colored red on the map, i.e. in the epidemic phase. “The flu curve seems to be a copy-paste of that of 2017, which had been one of the most deadly. The peak seemed to arrive the same day around January 10 or 15”, underlines with L’Express Benjamin Davido , infectiologist at the Raymond-Poincaré hospital in Garches. Five years ago, this epidemic was also early and severe, then carried by type A (H1N1) and B (Yamagata) viruses. So will history repeat itself?

“If the circulation of the flu is losing speed, hospitalizations and deaths continued to increase, particularly among people aged 65 and over”, adds Public Health France. On the mortality side, the agency observes a “4.5% increase” in flu-related deaths during the last week analyzed. According to the health authorities, caution remains in order because of the particular context: “The end-of-year holidays generally favor the reduction in the circulation of the flu, a rebound can be observed after the start of the school year”, cautiously advances Public Health France during a press conference given this Friday, January 6, “it is not excluded that a type B virus or another type A will take precedence in the weeks to come”.

“The finish line is not yet drawn”

For the past two weeks, the warm temperatures have also played in our favour. What will it be in two weeks? “The finish line has not yet been drawn, there is still the winter season to cross. The risk is that all respiratory pathologies will start to rise again”, answers Benjamin Davido. On the ground, the decrease in the flu epidemic is not yet felt among health professionals. “It is much too early to speak of hindsight. Flu cases represent between 20 and 40% of people treated in intensive care units”, indicates Djillali Annane, head of the intensive care unit at Raymond-Poincaré hospital. (AP-HP) of Garches. During this new school year, the flu continues to undermine care establishments that are out of breath. “If we didn’t have a completely down to earth health system, we wouldn’t be talking so much about the flu,” says the professional.

In its intensive care unit, 80% of the beds are occupied by patients suffering from a serious form of the flu. The majority of people present in the intensive care unit of Garches hospital are over 55 years old and are not vaccinated. “Our situation is not representative of reality, because we have a lot of beds closed due to a lack of staff. Therefore, we have to be more selective. Currently, almost all of our patients are on ventilation invasive,” he said. In the intensive care unit at Raymond Poincaré, six out of fifteen beds are closed. For now, the ten continuous monitoring beds have been maintained.

“We should not rejoice in a possible decline in the flu, because the vaccination coverage is not there”, continues Djillali Annane. On several occasions, health authorities have called on people at risk to get vaccinated against the flu and Covid-19, as the countryside is slipping this year. “Vaccination is still relevant with regard to the flu, as well as wearing a mask and washing hands of course in closed places and where there are very many of us,” insisted the Minister of Health, François Brown, December 28. One thing is certain: the decline of the flu should not make us forget the barrier gestures. “Apart from the flu, we risk taking a boomerang from the Covid-19 epidemic if we relax”, warns Benjamin Davido.

Towards an increase in bronchiolitis in adults

For its part, the bronchiolitis epidemic continued in mainland France as well as in Guadeloupe, Guyana, Martinique and Mayotte. It should be noted that the department of La Réunion entered the pre-epidemic phase this week. As a reminder, the bronchiolitis epidemic was very early this year, and of “high intensity” – compared to the previous ten years – according to Public Health France. But the agency noted a “decrease in emergency visits and hospitalizations after emergency visits among children under 2 years old in mainland France for the fourth consecutive week”.

“In terms of the share of bronchiolitis in all visits and all hospitalizations, we are at 15% and 35% respectively, which brings us back to values ​​comparable to those we had before. habit of observing on pre-Covid-19 epidemics”, estimates Sophie Vaux, epidemiologist at Public Health France. In addition, SOS doctor medical procedures for bronchiolitis have also decreased. What about adults? “Often, we notice an increase in cases of bronchiolitis in adults in the second part of the epidemic, once the pediatric peak has passed. This is the case this year”, recalls Sophie Vaux. Because of the extensive circulation of bronchiolitis in children, it is plausible that a similar circulation follows in older patients. “The epidemic is not at all over at this stage,” she concludes.