Extreme cold may put infants’ life at stake

Rawalpindi

With the setting in of winter in this region of the country, acute respiratory infections including pneumonia have taken shape of an epidemic as currently, the two allied hospitals in town operating paediatrics departments are receiving well over 2,000 child patients per day on average of which over 80 per cent are with ARIs.

Data collected by ‘The News’ on Saturday has revealed that Holy Family Hospital and Benazir Bhutto Hospital are receiving over 1,600 child patients with ARIs including over 500 patients suffering from pneumonia per day on average.

It is important that in routine, the two hospitals receive 800 to 1,000 child patients per day. At present, the HFH and BBH are receiving 250 to 300 child patients with severe pneumonia per day. Majority of patients being presented with pneumonia requires indoor treatment at the paediatrics departments operating at HFH and BBH.

Currently we are having more than 2,000 pediatric patients daily in our allied hospitals of which around 80 per cent are with acute respiratory infection (ARI). As many as 30 per cent of patients being presented with ARIs are with pneumonia, the major killer of children that kills well over 90,000 children in Pakistan every year, said Head of Pediatrics Department at Rawalpindi Medical College and Allied Hospitals Professor Rai Asghar while talking to ‘The News’ on Saturday.

He added that 10 to 15 per cent of child patients reaching allied hospitals are with severe pneumonia requiring indoor treatment.

Majority of child patients being taken to the allied hospitals are with cough, running nose and fever while some patients have fits due to high fever, he said.

He explained that severe pneumonia has respiratory distress, fast breathing and lower chest in-drawing and may have cyanosis. Refusal to feed or poor feeling is another important feature. Although respiratory syncytial virus is the most common organism causing pneumonia but clinically it is difficult to differentiate from bacterial pneumonia, said Dr. Rai.

As there is high mortality with pneumonia, nearly three million children dying of pneumonia per year, the WHO recommends to treat pneumonia with antibiotics, he said.

He added that clinically it is easy to pick pneumonia that has main symptoms of fast breathing and lower chest indrawing. Mothers can pick pneumonia by just counting respiratory rate in one minute and if fast greater than 60 till two months of age, greater than 50 from 2-12 months, and greater than 40 from 1-5 years, the child must be brought to a hospital, he said.

He said children with severe pneumonia having severe respiratory distress, cyanosis along with fast breathing and lower chest indrawing must need admission and the allied hospitals are admitting all like patients despite shortage of space.

It is important that the HFH has a 120 bedded ward and BBH has a capacity of 100 beds in its ward though currently 500 to 600 child patients are undergoing treatment at the two hospitals with the arrangement of two to three children sharing a bed.

To a query, Professor Rai said severe pneumonia is common in infancy and at this age mortality is also high. Majority of child patients have upper respiratory infection which is commonly viral and does not need antibiotics, he said.

He added that cough syrups and flu medicines available in markets for adults are not recommended for use in under five children. They may be dangerous. Paracetamol for fever, saline nasal drops for nose block and home safe cough remedies for cough can be given. Protect your children from cold weather. Breastfeeding and vaccination will protect from pneumonia, 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 Professor Rai.