Hospitals face winter 'tripledemic' of Covid, flu and RSV

Hospitals face winter 'tripledemic' of Covid, flu and RSV
The US and countries across Europe are facing a wave of winter illnesses including respiratory syncytial virus, which can be particularly serious for infants and the elderly.

RSV was virtually unheard of among the public before the Covid-19 pandemic but cases are surging, prompting some authorities to introduce emergency measures. Children under five, especially newborns, are most at risk of developing severe symptoms from RSV, which causes pneumonia and bronchiolitis. The number of babies under six months being presented at hospitals with RSV is seven times the rate recorded several years ago, according to data from the US government.

The rise has prompted some health authorities to erect tents outside hospitals in scenes similar to those a the height of the coronavirus crisis. Some hospitals have cancelled planned operations in anticipation of further influxes of cases.

Ireland, France, Spain and Sweden have also seen unusually early spikes in RSV cases and there have been rising paediatric hospital admissions due to the virus, according to the European Centre for Disease Prevention.

In England, hospital cases of flu shot up by almost 50 per cent in a week, the latest figures have shown. Infection rates are estimated to be highest among 15 to 44-year-olds, with 24.3 per cent of laboratory samples from this age group testing positive, according to the UK Health Security Agency. About 14 per cent of samples from all age groups tested positive in the week to December 4, up from 12.5 per cent the previous week.

The rising numbers on both sides of the Atlantic have given way to fears of a “tripledemic” of Covid, flu and RSV, which could overwhelm hospital wards.

Dr Carissa F Etienne, director of the Pan American Health Organisation, said last month that the rising numbers of viruses across the Americas was concerning.

“The rise of a single respiratory infection is a cause for concern,” she said. “When two or three start impacting a population concurrently, this should put us all on alert.”

The UK has been experiencing a surge in cases of Strep A, which has led to the deaths of 15 children in recent weeks.

Group A strep bacteria can cause infections ranging from minor illnesses to deadly diseases. llnesses caused by Strep A include the skin infection impetigo, scarlet fever and strep throat.

While the vast majority of infections are relatively mild, sometimes the bacteria cause a life-threatening illness called invasive Group A Streptococcal disease.

Pharmacists have been reporting a shortage of penicillin, which is prescribed to children with severe cases of Strep A. UK Health Secretary Steve Barclay insisted on Wednesday that checks within the Department of Health have not revealed an issue with supply of the medicines.

Professor Sir Andrew Pollard, a leading British immunologist and chairman of the Joint Committee on Vaccination and Immunisation, said he is not aware of any “national shortage” in antibiotics to treat Strep A.

He told BBC Radio 4’s Today programme that the bug is “always sensitive to penicillin so it should be perfectly treatable when it’s recognised”.

Prof Pollard said Strep A causes “a lot of asymptomatic infections where it’s completely harmless” and therefore no treatment is required. “What we’re seeing at the moment is this rise in infection, particularly with the alarm bells of the increased numbers of scarlett fever cases, which tells you that there’s more of a problem,” he said. “You don’t actually need mass testing to tell that that’s happening.

“As far as giving antibiotics to large numbers of individuals, that generally has not been the approach that has been taken because you end up giving antibiotics to a lot of people who don’t need it, huge numbers of people who don’t need it. Here, we’re talking about particularly children. And so this is very much currently being restricted to where there is a concern that there’s an outbreak of the more severe disease happening in schools or nurseries.”

He said local public health guidance should be followed when deciding if an entire class of children should be prescribed antibiotics.
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