Damian Roland Profile picture
Oct 1, 2021 9 tweets 5 min read Read on X
Time for a Bronchiolitis round up courtesy of @UKHSA

[Bronchiolitis is caused by a virus called RSV]

The international data has very interesting implications for us!

Remember you can follow #Bronchstart study data here: beta.microreact.org/project/cTkH24…

@PERUKItweep @MyMicroreact
So USA saw a sharp increase for 3-4 weeks followed by a subsequent decrease in detections.
Peak was similar to 2019 season however began in May (c.f. normal September-October).
Increase sustained until early September 2021, a longer peak than the previous year. Image
Canada has had an increase in number of RSV positive tests than usual for the same time period (grey dash is 6 year average)

This is in keeping with decreased immunity (children not exposed in 2020) along with the current increase in social mixing. ImageImage
Both Western Australia and New South Wales (NSW) reported a sharp increase and then decrease in RSV detections.

(there was also an increase in adult RSV hospitalisations at the same time as paediatric ones) ImageImage
In New Zealand the 2021 trajectory was much larger and steeper than the trend of RSV in 2019.

The peak occurred slightly earlier (~1 month) than 2019, but not completely out of season as seen in other countries. Image
Japan experienced a sharp increase in RSV detections, with a peak three times the average previous five years in Japan.

The epidemic lasted approximately 10 weeks, mirroring previous outbreaks, but occurred 2-3 months earlier and was much larger. Image
So other countries have had out of seasons peaks like us BUT they have had either larger peaks than usual or they have been more sustained.

Current data suggests our bronchiolitis surge, which started in August, is slowing down... Image
BUT modellers think residual susceptible population in all regions is large enough to sustain activity and potentially be sufficient to drive a spike in activity during the normal Winter RSV season

Worrying hospitalisations at a lower rate - indicating may be more to come... Image
We'll be able to use #BronchSTART dashboard to see how presentations versus admissions pan out over next 8 weeks.

It's possible we've had our Bronchiolitis surge for this year, but we need to see some year-on-year data to confirm whether numbers would support that conclusion.

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More from @Damian_Roland

Feb 25, 2021
Now good evidence to back up the worldwide reports of out-of-season surges of bronchiolitis.

This should cause significant reflection in the UK paediatric community as rapid service response may be needed at a time when staff in a traditional summer 'down time'

/thread
In November 2020 the Western Australian surveillance programme demonstrated a rapid rise in respiratory syncytial virus (RSV) cases.

RSV causes bronchiolitis, a common respiratory infection, in children less than one year old.

This was interesting as case numbers were not only occurring in the summer (unusual as it is normally a winter illness) but also at a much greater frequency (up to double normal seasonal levels)

The reasons for this aren't clear but was thought to be a rebound effect of lockdown
Read 7 tweets
Jan 3, 2021
The SAGE Children’s Task and Finish Group: update to 4th Nov 2020 paper on children & schools is used a lot to justify shutting schools.

assets.publishing.service.gov.uk/government/upl…

This isn’t what document suggests but highlights the challenges that current exist.

It’s not black and white.
Worth noting that teachers no more at risk (at time of publication) than other professions.
But also that 12-16 and 17- 24 had higher positive rates.

There is widespread geographical variation. This makes it difficult to apply a one size fits all solution.
Read 4 tweets
Jan 2, 2021
Do my level best not to propagate mis-information - which this from @bbc5live definitely is- but now this tweet has had over 1 million views I think important all in child health make absolutely clear we are not seeing a nationwide wave of #COVID19 induced illness in children.
And apologies to Laura Duffel as this is aimed directly at @bbc5live who have placed no context on this statement, I suspect knowing it would be likely to raise eyebrows.

Exactly everything we don’t need from journalism at present.
And to be crystal clear, the tweet was worded as to be technically correct. This is what frustrates me most.

The lack of a second, or linked tweet, highlighting the correct context demonstrates to me this was being deliberately provocative.
Read 4 tweets
Jun 27, 2020
There has been justifiable concern about the impact of #COVID19, and particularly the lockdown, on children.

Our @LancetChildAdol paper evaluates delayed presentations to Emergency Departments (and it's not what you think)

thelancet.com/journals/lanch…

/Thread
Early reports from Italy highlighted significant concern with children presenting late to hospital and coming to harm.

It's important to note in some of these cases advice not to present had come from previous contact with medical professionals

thelancet.com/journals/lanch…
Anecodote and early reports in the UK supported this but it's important to recognise there is no definition of delayed presentation

There is no gold standard to suggest when a parent should bring a child to hospital
Read 15 tweets

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