Co-infection not seen in city but kids responding late to treatment

Nagpur: City paediatricians have not seen simultaneous infections such as Covid-19, swine-flu and influenza A among kids reporting with cough, cold and high grade fever in the city as compared to those seen in other parts of the state. Though qualifying as viral infection, the fever is persisting for more than 72 hours with many even requiring hospital admissions in private and public hospitals.
Many infected kids also have shown white lungs indicating severe pneumonia but those cases haven’t required mechanical ventilator support so far, the doctors said.
Doctors have called it atypical viral infection as the response to treatment is taking more than a week’s time. In pre-Covid times, this type of infection would go away within a week.
“More than 90% kids coming in OPD are all having viral infection suspected to be influenza A, adenovirus or rhino virus. Fortunately, they are being managed on anti-viral treatment. We had feared that some kids with severe pneumonia may require ventilator support. But they were managed by non-invasive ventilator,” said paediatrician Dr Sanjay Deshmukh.
Dr Deshmukh said the number of cases are high as kids couldn’t acquire natural immunity during lockdown. “All kids require anti-viral. Though viral infection is self-limiting and basic investigation is normal, kids are taking long to respond,” he said.
Paediatric pulmonologist Dr Shilpa Hazare said the viral wave is affecting bronchial asthma patients as well as kids. “Viral infection is getting severe and within a couple of days. Kids are needing ICU and O2 support. It is most likely due to influenza A subtype H3N2 though we are not going for test in each patient as it is expensive,” she said.
Dr Hazare said the incidence of adenovirus is low now while hospitalization rate too is going down. “Around 15 days back, the patient flow was heavy. The worst seems to be over,” she said.
Dr Hazare said, “Less than two-year-old kids are needing admission more frequently as the size of their breathing pipe is narrow which makes them more vulnerable to breathlessness. But a week’s time in hospital is enough for them. Some kids require non-invasive because of respiratory distress too.”
Paediatric intensivist Dr Vivek Charde said viral infections are rampant since last one month. “Adenovirus, influenza, rhinovirus and dengue-like illness are everywhere all across India. The problem is severity of symptoms. Very high grade fevers even upto 105 degrees F are seen, and kids do not respond to paracetamol and other similar drugs. A few children have non-remitting vomiting and loose motions causing severe dehydration,” he said.
Dr Charde added, “These symptoms are sometimes persistent for 5-7 days. Meticulous care during this period is very important to avoid future complications. Taking care of hydration, temperature control and maintaining oral intake is important. If symptoms are severe, then hospitalisation may be necessary.”