THE ESSENTIAL
- Acute bronchiolitis is a respiratory disease of viral origin that mainly affects children under 2 years of age during seasonal winter epidemics, according to Santé Publique France.
- Epidemiologists recall the importance of vaccination once morest bronchiolitis.
Have wearing a mask and the sanitary measures linked to Covid-19 made us more susceptible to infections? This theory ofimmune debt“, which is currently at the heart of debates between pediatricians and epidemiologists, would explain the virulence of the current epidemic of bronchiolitis.
The bronchiolitis epidemic linked to anti-Covid measures?
In other words, by dint of protecting our immune system and less exposing it to viruses, it would not have been stressed enough. Thus, we would now be more susceptible to certain diseases and viruses, including RSV, responsible for 50% and 80% of cases of bronchiolitis in France.
“The hospital is under tension, very strong in paediatrics, with an epidemic of bronchiolitis which was early, which is very intense. Why is she so intense? Precisely because for two years, we wore masks, and since it’s a respiratory virus, we had protection, so we had an epidemic that was very weak, we had less immunization of the little ones, and suddenly, as there is a collective relaxation, the virus circulates very strongly, it circulates earlier, and therefore there are many children who are sick”, summarized the former Minister of Health, Olivier Véran, on November 13 on BFM TV.
Beginning of November, Public health France had indeed reported hospitalizations at record levels”for more than ten years“with regarding seven thousand emergency room visits in the last week of October. And according to his last epidemiological of November 16the bronchiolitis epidemic continues at “a very high level in mainland France”. Also this year, the epidemic was six weeks ahead of the classic seasonal cycle which sees bronchiolitis usually start in mid-November.
“Immune debt” is not scientifically proven
This notion of “immune debt” appeared in a text by French pediatricians published in Infectious Diseases Now in August 2021 and is being debated within the scientific community.
On his twitter account, epidemiologist Antoine Flahault writes that this concept is above all “the illustration of our great ignorance in the field of immunology. Instead of saying “I don’t know why we have this level of bronchiolitis”, some scientists, especially doctors [et] especially paediatricians, rush into it without restraint. We have considerably cleaned up – on a microbiological level – our lifestyles for a century. [Or] instead of paying our digestive, cutaneous, genital and respiratory immune debt, we have seen infectious diseases melt away and life expectancy more than double”.
Brigitte Autran, professor emeritus in immunology at the Faculty of Medicine of the Sorbonne and president of Covars (the Committee for monitoring and anticipating health risks) explains in Release that it is however difficult to know exactly whether this reduction in exposure to many pathogens has favored more infections at the end of the Covid-19 crisis.
Finally, it is also difficult to speak of debt because “it is impossible to quantify the amount of stimulation that the immune system would need”, explains Brigitte Autran.
