We spoke with Manuel Sánchez-Solís de Querol, head of the Pediatric Service at the Virgen de la Arrixaca University Hospital, about the peculiarities of this disease in babies with Down syndrome.
Most of the time it is nothing more than a common cold. However, in children under one year of age and in their first infection with this virus, bronchiolitis manifests itself with a low-grade fever, a cold for one or two days, followed by difficulty breathing and a respiratory noise called “wheezing,” which is often known as “whistles.”
As it is a disease caused by viruses, antibiotics should not be administered, and we do not have an effective treatment. Oxygen is administered if necessary and other measures are applied to alleviate the disease or prevent complications.
Well, it is not very clear why this is so. There is probably more than one reason: children with Down syndrome have a less functioning immune system and often have heart malformations and higher lung pressure. But we don't know the exact reason.
The essential thing is to prevent infections, especially in young children: extreme hygiene must be exercised, avoiding, as far as possible, contact with sick people and siblings with a cold, washing hands very well, as well as the objects with which the child comes into contact, especially if he puts them in his mouth (bottles, glasses, spoons, pacifiers, rattles...). Some diseases are preventable through vaccines - such as the flu - and, when indicated, with the use of palivizumab, which is an antibody to prevent respiratory syncytial virus infection.
They are children at higher risk. There is data from around the world that bronchiolitis is more common and severe in these children. It is also especially important to know that the risk is even greater in children with Down syndrome who have heart malformation or pulmonary hypertension.
Yes, it can be a more serious illness and require hospitalization.
Patients with Down syndrome and heart disease should receive palivizumab (antibody to prevent RSV infection) during the first 2 years of life and, obviously, put into practice the general prevention measures that have already been mentioned.
Emergencias
Los responsables de la salida deben tener perfectamente previsto cómo actuar en caso de emergencia. Lo normal es que no suceda nunca nada, pero no se puede dejar en manos del azar qué hacer en caso de que un niño se pierda o se caiga, de que se averíe el autocar o simplemente de que alguno vomite durante el trayecto.
No improvisar
Las salidas hay que prepararlas con antelación e improvisar lo menos posible. Es fundamental que la escuela tenga todo reservado y que les estén esperando en el destino elegido. También conviene que las necesidades fisiológicas de los pequeños estén cubiertas antes de salir: por muy cerca que vayan, será necesario hacer una ronda de pises y cacas para evitar escapes y sorpresas desagradables. En cuanto a los padres, recordemos que ese día los niños no deben llevar juguetes ni nada que no indique su profesor.
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