Bronchiolitis in children ≤ 12 months during the pre-flu season of 2024: A case series

Abstract

Background: In March 2024, the National Institute for Communicable Diseases (NICD) warned against a respiratory syncytial virus (RSV) outbreak during the pre-flu season, 2024. Globally, RSV is responsible for most respiratory infections in young children. Since April 2024, we have noticed a more severe presentation of children with bronchiolitis at the National District Hospital, Bloemfontein. We aimed to investigate the causative organism/s and the appropriateness of the treatment guidelines in our setting.

Methods: A retrospective file review was carried out as part of the normal audit process. All children admitted with bronchiolitis during the 4-week study period were included in the case series. Ethical approval was obtained from relevant authorities.

Results: Ten children ≤ 12 months presented with bronchiolitis symptoms. The Modified Tal Score was measured, with values between 8 and 12, indicating moderate and severe bronchiolitis in all cases. The demographics regarding gender, nutrition and vaccination status did not differ from previous years. Influenza A was identified in 60% of the cases, with RSV in only 20% of the cases. All the children responded well to symptomatic treatment and recovered.

Conclusion: Most bronchiolitis cases were caused not by the predicted RSV outbreak but by Influenza A.

Contribution: Despite presenting with severe symptoms, all the children responded to symptomatic treatment as set out in our guidelines.