Por Paula Laboissière – Repórter da Agência Brasil
O Ministério da Saúde anunciou esta semana que vai incorporar ao Sistema Único de Saúde (SUS) uma vacina recombinante contra o vírus sincicial respiratório (VSR), uma das principais causas de infecções respiratórias graves em bebês, incluindo os temidos quadros de bronquiolite.
Trata-se da vacina Abrysvo, produzida pela farmacêutica Pfizer. Segundo o ministério, a dose será aplicada em gestantes visando proteger o bebê ao longo dos primeiros meses de vida. A portaria oficializando a incorporação e detalhando o esquema vacinal deve ser publicada nos próximos dias.
VSR e bronquiolite
De acordo com a Sociedade Brasileira de Imunizações (SBIm), o VSR figura como um dos principais vírus associados à bronquiolite, quadro caracterizado pela inflamação dos bronquíolos – pequenas e finas ramificações dos brônquios que transportam o oxigênio até o tecido pulmonar.
Segundo a SBIm, o vírus circula com maior intensidade no inverno e no início da primavera, períodos em que pode causar epidemias. No Brasil, a sazonalidade do VSR varia conforme as diferentes regiões do país. Surtos em outras estações do ano, entretanto, não são incomuns, sobretudo em países de clima tropical.
“Quase todas as crianças são infectadas com VSR pelo menos uma vez até os dois anos de idade. Recorrências em outros momentos da vida são comuns, uma vez que a infecção não proporciona imunidade completa, mas, em geral, são menos graves”, destaca a SBIm.
Nos Estados Unidos, por exemplo, o VSR é responsável por mais de 50 mil hospitalizações entre menores de cinco anos. Já no Brasil, dados da Secretaria de Atenção Primária à Saúde indicam que o vírus é responsável por cerca de 80% dos casos de bronquiolite e até 60% dos quadros de pneumonia em crianças menores de 2 anos.
De acordo com a SBIm, algumas condições crônicas aumentam o risco de infecção grave por VSR: doença pulmonar obstrutiva crônica (DPOC) e a asma; doenças cardiovasculares, como insuficiência cardíaca congestiva e doença arterial coronariana; imunocomprometimento moderado ou grave; diabetes mellitus; distúrbios renais e hepáticos; e distúrbios hematológicos.
Sintomas
A maioria das crianças infectadas pelo VSR apresenta sintomas leves, geralmente semelhantes aos de um resfriado comum. Em menores de dois anos, entretanto, a infecção pode evoluir para sintomas mais graves e associados à bronquiolite.
Inicialmente, há coriza, tosse leve e, em alguns casos, febre. Em um a dois dias, pode haver piora da tosse, dificuldade para respirar, aumento da frequência respiratória – com chiado a cada expiração – e dificuldade para mamar e deglutir. Como sinal da menor oxigenação, pode haver azulamento de dedos e lábios.
Diagnóstico e tratamento
O diagnóstico, de acordo com a SBIm, é clínico, mas a identificação e a confirmação de infecção por VSR são feitas somente por meio de exames laboratoriais, incluindo testes rápidos e ensaios moleculares, como PCR-RT, que detectam o antígeno viral.
“Não há tratamento específico para o VSR. Diante de um quadro grave, é imprescindível a hospitalização para oxigenoterapia e outras medidas de suporte. Pode ser necessário o uso de respiradores mecânicos, em ambiente de UTI [unidade de terapia intensiva], destacou a entidade.
“A maioria dos pacientes inicia a recuperação em cerca de sete dias e se restabelece totalmente. Entretanto, crianças podem desenvolver alterações respiratórias crônicas e tornam-se mais propensas à asma no futuro”, completou a SBIm.
Transmissão
O VSR é transmitido pelas secreções do nariz ou da boca da pessoa infectada, por contato direto ou por gotículas. A transmissão começa dois dias antes de aparecerem os sintomas e só termina quando a infecção está completamente controlada. O período de maior contágio é nos primeiros dias da infecção.
Foto: © Tomaz Silva/ Agência Brasil
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