Hospitals are calling for alert, because there is a remarkable increase in patients with flu and on top of that a bacterial infection. ‘We even have a girl here who is barely 17 years old,’ says Pascal Van Bleyenbergh, head of the respiratory infections department at UZ Gasthuisberg Leuven.
The flu is in the country and, according to Sciensano, all criteria for a flu epidemic have been met. The hospitals have of course known this for some time, because in addition to an influx of corona and RSV patients, they have seen more and more patients with flu occupy the scarce beds in the past two weeks. In most hospitals the maximum capacity has almost been reached, in the UZ Gasthuisberg in Leuven they are over it. As a result, 30 percent of planned recordings must be postponed. Just like at UZ Gent, they see remarkably more patients at UZ Leuven with an additional bacterial infection on top of the flu.
Local immune system
“There is no clear explanation for the increase. Is our general immunity diminished? Is it because we have been immune from contact with bacteria for two years as a result of corona and are now exposed once more?”, doctor Pascal Van Bleyenbergh (UZ Leuven) returns the question.
“Due to the mask obligation, we have shielded ourselves from viruses and bacteria for a long time. Maybe that makes our system a bit less strong, but that’s actually speculation. However, the fact that a flu is sometimes accompanied by an additional bacterial infection is not new. Here’s the thing: you have a general defense system – the immune system – but you also have a local defense system. In principle, the local immune system will prevent a bacterium from entering the bronchial tubes, but when you have a viral infection, that system does not work as well. Your airways are inflamed, there is much more mucus and the like and that makes it easier for the bacteria to enter. And we really see that much more often now.”
It is impossible to say how many more patients end up in hospital in this way. “I don’t have any statistics on that, but I can count on an increase of 30 percent,” says Van Bleyenbergh. “We often hear how it started with ‘the flu’, a viral infection, and ends with bacterial pneumonia. Because of the band you can say that 10 percent of people with pneumonia have to go to the hospital. We now see that our department is packed, all the beds allocated to lung diseases – we have just under a hundred – have been taken and we have also taken beds in other departments. 40 percent of all lung pathologies are infections.”
According to Van Bleyenbergh, this inexplicable increase is reason to remain alert. “We come from a time when just regarding all of us have had a viral infection and we know that viral infections do not warrant the use of antibiotics. But therein lies the danger,” he says. “Now suppose you have a valling have a headache, sore throat and runny nose. Then you may have a viral infection. A high fever is a symptom of the flu and does not necessarily indicate a bacterial infection.”
“But there is a chance that you will get a bacterial infection followingwards because you are more susceptible to it. The complaints are regarding the same – maybe a little more coughing and phlegm – but they are not always thought regarding, so that treatment with antibiotics is started too late. This is not a plea for more antibiotics, but if it really is a bacterial pneumonia and you start antibiotics too late, you have an increased risk of complications and an increased risk of hospitalization. I don’t blame general practitioners: we’ve been going through a wave of infections for two years now, everyone coughs and sniffles, and then it’s not easy to weed out patients with a bacterial infection. But we have to be alert, given that there are clearly more cases, and perhaps use antibiotics in a slightly more accessible way than usual.”
More young patients
Another striking fact: more young people with pneumonia have been admitted to UZ Gasthuisberg. “We have a girl here who is barely 17 years old with pneumonia and we have also had people in their twenties and thirties in recent weeks. However, young people are less likely to get pneumonia and even less likely to end up in hospital. But we cannot ignore the fact that there is an increase. Be careful, there aren’t hundreds of them. We started the week with 34 patients with a respiratory infection, 7 of them were on the young side, but the majority are over 65 and mostly very old. Anyone can get sick: there is corona, RSV and influenza. We mainly see vulnerable people pass by in our department, but in your own environment you notice that just regarding everyone falls prey.”
