Respiratory tract infections on the rise among children

Rawalpindi

Extreme cold wave has hit this region of the country after the recent rains and the existing chilly weather conditions may put children at greater risk of contracting both the lower and upper respiratory tract infections including pneumonia that has already taken shape of an epidemic among local population.

With the rains, the quality of air has improved through cleansing and it may be beneficial for adults and help control the respiratory tract infections and asthmatic complications but for children, the case is the other way around as the fall in temperature below 10 degree centigrade is risky and may cause severe problems including pneumonia among children if proper preventive measures are not taken well in time.

The Paediatrics Department of Rawalpindi Medical College operating in two of the three teaching hospitals namely Holy Family Hospital and Benazir Bhutto Hospital is already receiving heavy influx of child patients with both upper and lower respiratory tract infections including pneumonia. After the recent rains that has turned the weather much chilly, it is expected that the number of child cases with pneumonia would go up further.

Head of Paediatrics Department at RMC Professor Dr. Rai Muhammad Asghar expressed this while talking to ‘The News’ on Saturday adding that out of a total 900 to 1,000 child patients visiting allied hospitals daily for treatment, 70 to 80 per cent are being reported with acute respiratory infections including colds, sore throat, runny nose, cough, fever and flu. Of these patients, not less than 30 per cent are reported with pneumonia, he said.

It is important that pneumonia kills over 90,000 children below five years of age every year in Pakistan.

To a query, Dr. Rai said the allied hospitals are receiving 250 to 300 child patients with mild to severe pneumonia per day on average and the number is continuously on the rise however only 50 to 60 of these required admission because of having severe pneumonia. Majority of cases being reported with pneumonia are of infants around the age of six months, he said.

He said the allied hospitals admit all the child patients of severe pneumonia being reported at the paediatrics departments of BBH and HFH.

It is important that the HFH Paediatrics Department has 120-bed capacity and the BBH has 100 beds ward though not less than 500 child patients are undergoing treatment at the two hospitals.

We have to keep two to three children on one bed to accommodate maximum number of patients, said Dr. Rai. He added that on average, 500 to 600 child patients remain admitted at the allied hospitals every day.

To a query, he said after the setting in of extreme cold weather, the number of child patients being reported at the allied hospitals with complications of asthma and wheezing is also on the rise. There may be a number of causes behind spread of respiratory tract infections among local population but the most important fact is that most of the parents do not follow proper preventive measures, he said.

It is need of the time to create awareness among parents that pneumonia is one of the top killers of children below five years of age and its incidence should not be taken as lightly because through prevention and in time management of the cases, more than 70 per cent of the deaths caused by it can be avoided.

He explained that fast breathing and lower chest wall indrawing are the main symptoms of pneumonia that may be because of two major organisms including Bacteria Streptococcus Pneumoniae or Haemophilus Influenzae. A patient of severe pneumonia suffers from difficulty in breathing with severe respiratory distress along with central cyanosis in which colour of hands and feet particularly gets bluish, he said.

He said a child patient of severe pneumonia requires admission to the hospital while simple pneumonia patients can be treated at home but the patients must be taken to the healthcare facilities immediately for proper advice.

For prevention, he said children below five years of age must be administered pneumococcal vaccine and haemophilus influenzae type B (Hib) vaccine which is available under Expanded Programme on Immunization. Both the vaccines are available at the allied hospitals free of cost, said Dr. Rai.

To avoid upper and lower respiratory tract infections including pneumonia, children should be protected from cold by using proper warm clothing while infants should be breastfed at least for two years. The most important thing to avoid pneumonia is to keep children in clean environment and their rooms must have good ventilation, he said.

To avoid pneumonia, the infants and children must be kept dry, their wet clothes must be removed immediately and their rooms must have proper ventilation, said Dr. Rai.

To a query, he said the cough syrups for adults and medications available in market for management of flu and colds in adults are not recommended for use in infants and children particularly below five years of age as consumption of these may be life-threatening.

The cough syrups and medicines for management of respiratory tract infections among adults may increase heart rate among infants and children and they may face severe distress in respiration, said Dr. Rai. He added that medicines for adults if used for management of respiratory tract infections among infants and children can cause death.