Life returns to normal. After 20 months managed by the pandemic, Spain begins to recover its routines, its encounters, its travels and its hugs. Even if it is with the mask in tow. A normality that also affects the world of viruses, bacteria and diseases.
According to experts, the pneumococcus is already here and will make its way this winter hand in hand with the flu and the covid. An autumn and winter complicated by respiratory diseases are coming, although there is good news: there are effective vaccines for all three and with the use of the mask the risk reduction is guaranteed.
This is indicated by José Yuste, scientific head of the Pneumococcal Reference Laboratory of the Carlos III Health Institute, who advanced an increase in cases of pneumococcal diseases with the decrease of the covid virus. Pneumococci are beginning to take up a space that SARS-CoV-2 took away from them last year, just like the flu.
The pneumonia vaccine is planned for babies and over 65, but in these it has low coverage
But everything suggests, he points out, that pneumonia will reappear at the levels of 2019, the year in which pneumococcal diseases caused 11,000 deaths. “The increase is just around the corner and it can be a public health problem,” warns Yuste.
For now, this fall’s respiratory infections resemble those of pre-COVID seasons: they start with those under five. An increase in syncytial viruses that cause bronchiolitis in children is already noticeable, “but they are rising in parallel to what happened in 2019-2020,” says Tomás Pumarola, head of Microbiology at the Vall d’Hebron hospital. “Respiratory infections of all kinds are increasing, but for now in a number and characteristics similar to other years at this time,” confirms Carlos Rodrigo, clinical director of pediatrics at Germans Trias de Badalona. “Every year it occurs a few weeks before or after, and the onset and rate of increase in cases is within expectations. And still there is practically no flu ”.
Read also
Last season, due to covid, there was a reduction in cases of pneumococcal infections in children of 53% and 61% in adults. Pharmacological measures are behind this significant decline. “But with the return to normality, we began to notice a rebound in these diseases,” says Yuste.
Pneumonia experts claim to take advantage of trust and protect against all three infections
“The logical thing this year would be for us to follow the same guidelines as in 2019,” says Antoni Trilla, head of epidemiology at the Barcelona Clinic. “With a mask, yes, but without major alarms.”
Esther Redondo, section chief of the Madrid International Health and Vaccination Center, who yesterday participated in a meeting with the media on the occasion of world pneumonia day, explains that this is a risky disease, especially for children and those over 65 years of age (15 cases or more per 1,000 inhabitants).
Between 20% and 25% of cases require hospitalization, and of these, 10% require mechanical ventilation support and admission to the ICU. At this time, it is the eleventh cause of death in Spain, according to data from the National Institute of Statistics (INE).
The respiratory disease caused by pneumococcus causes 11,000 deaths each year in Spain
Its origin is frequently bacterial, although 15% is linked to viruses, such as influenza or covid. In fact, Redondo explains, the vast majority of hospital pneumonias in the last year have been due to covid and according to the latest epidemiological surveillance data for respiratory diseases, all serious cases are due to SARS-CoV-2.
Pneumococcus is a bacterium that causes serious diseases such as meningitis, bacteremia or pneumonia (invasive diseases), as well as other less serious diseases such as sinusitis or otitis media.
“Pneumococcal diseases cause a lot of suffering and pose a high economic burden to the world of work and consume many health resources (an admission for an episode of pneumonia costs around 5,000 euros). Mortality is high (11,000 in 2019), but a lower 10-year survival has also been found. Because the symptoms persist in many patients, affecting the heart, persistent fatigue, chest pain. “Many older people who coped without problems before pneumonia, after overcoming it, require a third party for basic needs.”
At the moment there are no more cases than expected and respiratory viruses are increasing at the rate of 2019
The good news is that, as for covid and flu, for pneumococcal diseases there is a vaccine. And they are very effective, they can be used throughout the year and “can be combined without problem with those of the flu and covid”.
In children there are no problems, since the vaccine is included in the vaccination schedule and parents do not skip this protection. The problem is in those over 65 – also included in the vaccine schedule for pneumococcal disease – as well as for people with chronic diseases at risk and the immunosuppressed. “The coverage of the pneumococcal vaccine in those over 65 years of age is usually even lower than that of the flu without making much sense,” says Antoni Trilla. “From 65, you have to offer it systematically, as is done with the flu.”
It can be administered taking advantage of the appointment for the flu and, where appropriate, the third dose of the covid. Coverages are surprisingly scarce, on the other hand, more due to ignorance than because they do not want to put it on. “What has happened with the covid demonstrates the widespread confidence in vaccines,” says Arroyo. And the experts defend that it is necessary to take advantage of that good reputation to install the routine also in the pneumococcal one.
This triple vaccination against respiratory problems in the group of people most at risk, those over 65, would drastically reduce respiratory infections in this year of recovery from normal viruses along with covid, which for now is still the one that creates more serious problems. The flu, which usually becomes an epidemic with Christmas, still circulates very little and in its first appearances it has not given good news: the variants that are most seen do not coincide with the combination of the vaccine. But it is still too early to know which will be the predominant year this year.
–
