CAMAGÜEY.- To inquire about pneumonia in pediatric ages, we went to Dr. Yanet Loret de Mola Bueno, 1st. Degree in Comprehensive General Medicine (MGI), 2nd. Degree in Intensive Care and Pediatric Emergency, from the Eduardo Agramonte Piña Provincial Pediatric Hospital.

The also Master in Infectious Diseases and Assistant Professor of the University of Medical Sciences of Camagüey announced that it consists of the acute inflammatory process of the lung parenchyma (tissue responsible for gas exchange) of infectious cause, evidenced by age-dependent clinical manifestations, the nutritional status of the child and the cause of pneumonia. This condition is accompanied by inflammatory infiltrates on chest radiographic examination.

—How does pneumonia behave in children in terms of number of cases?

—It is a frequent reason for pediatric consultation and hospitalization. It is the main infectious cause of death in children around the world, it occurs more frequently in children under five years of age and they are those with the greatest possibility of suffering from severe pneumonia, hence the possibility of exhibiting the highest mortality rate and within them, children under one year of age make up the most vulnerable age group.

“It is seen more frequently in males, who are more susceptible to acquiring infections, because in females the XX chromosome (responsible for providing greater immune support in the first period of life) influences. Such consideration means that the male sex is considered, for only that reason, a risk factor ”.

—What are other risk factors?

"The young age." There is a higher incidence in children under five years of age, due to the low development of the defense mechanisms of the respiratory system and having greater immunological immaturity, in addition, due to the frequent viral infections in young children, which affect the local defense mechanisms of the respiratory system and predispose to the acquisition of pneumonia. Low birth weight, prematurity and malnutrition are important risk factors. Basic chronic diseases, such as heart disease, kidney disease, among others, promote the acquisition of this ailment by immunosuppression (low defenses), the absence or early suspension of exclusive breast milk and the lack of immunizations (incomplete vaccination) have the same influence ).

“We cannot forget the indoor air pollution caused by the use of biomass (example: firewood or excrement) as fuel for cooking or heating the home. Overcrowding and tobacco use by parents increase the risks of acquiring pneumonia ”.

--"When can you be sure that we are dealing with severe pneumonia?"

—When a persistent and high fever appears, that is, 38.5 ° C or more, signs of respiratory failure due to high and rapid respiratory rate (tachypnea), respiratory whine, nasal flaring, generalized pulling (chest retractions, between and below the ribs, above the clavicles and sternum), paradoxical movement of the abdomen and chest during respiration, perioral, nail, or generalized cyanosis (bluish discoloration of the skin and mucosa).

“In the child under one year of age we see the appearance of head movements during breathing.

“The inability to drink or vomiting of everything ingested is added, it can decrease the amount of urine, and the abdomen becomes inflamed or distended. All these signs that speak of the appearance of serious complications.

"Such clinical manifestations, and in young children, less than one year old, rejection of the breast, weakness or irritability, crying a lot or sleeping more than usual, are alerts for the family to realize that their baby suffers of this affection ”.

--"Are pneumonia avoidable?"

—By knowing and avoiding the risk factors that predispose to acquiring it, we can reduce its incidence and prevent the appearance of serious pneumonia. Special care should be taken in prenatal care for pregnant women in order to avoid prematurity, low birth weight before and after.

“It is also important to offer exclusive breastfeeding to children up to six months old. In case the child suffers from a disease base strictly comply with the treatment and medical indications, as well as their follow-up by the indicated specialists. Avoid overcrowding, do not smoke at home, or in any place where the child is, or handle the baby after having smoked as they inhale the nicotine adhering to clothing and hair.

“It is essential to comply with the vaccination schedules for children, maintain adequate household hygiene, wash your hands frequently, both those of the child, as well as those of the parents or caregivers. Do not allow the little one to be in contact with sick people ”.

—Which doctor to go to if the child falls ill?

—Before the appearance of any symptoms, take the child immediately to the family doctor who will evaluate him in a timely manner and will indicate treatment and follow-up of the same. In case of needing interconsultation, he will ask the pediatrician for his evaluation.

—How has this type of condition behaved in times of COVID-19?

—The COVID-19 pandemic has spread to almost all countries and territories, including Cuba, constitutes a challenge to global health. The SARS-CoV-2 virus is transmitted through droplets generated when patients cough, sneeze, or speak. It is suffered by those people who live, study, work or have other forms of close contact with a suspected patient or individual. Drops containing the virus are also deposited on the surface of objects, which can be touched with the hand and the virus can pass from the contaminated hand to the mucosa of the mouth, nose and eyes and cause an infection.

"The use of the nasobuco, social distancing and proper hand hygiene, are the recommended measures to control transmission, which are just as effective in preventing the spread of acute respiratory infections in general, including pneumonia, therefore which has been able to reduce the incidence of pneumonia and its serious forms in all pediatric age groups, in times of COVID-19 ".

—From your experience, which of the measures adopted to avoid the spread of COVID-19 should remain as daily habits?

—When the pandemic has passed, we must continue with proper hand hygiene, at home and in places where children are, such as schools, day care centers, it should be a valuable aspect to consider. Avoid exposing our children to crowds and crowds. Do not kiss them on the face, or on the little hands, do not talk to them close by, their mother would only be admitted if she is not ill and if she presents any condition, she should use the nasobuco when coming into contact with the little one and wash her hands frequently to manipulate him, his food and his objects.

“It is vital not to allow the child to be around other sick people under any circumstances. Comply with the vaccination schedule that corresponds to them. Do not expose them to contaminated environments, or smoke in the places where they are ”.

--"Could you suggest a rule of thumb to avoid pneumonia or other respiratory infections?"

—There is no other more effective than prevention through targeted measures. Let's take care of our children.

• Translated by Linet Acuña Quilez