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(Adnkronos Salute) - "Ho grande fiducia" per contrastare l'infezione da virus respiratorio sinciziale (Rsv) nella prossima stagione, "perché abbiamo gli strumenti" efficaci. "Ma ho anche una grande preoccupazione, perché ancora non tutte le Regioni si sono attivate per predisporre una campagna che possa contare su uno strumento di immunizzazione universale efficace come la nuova generazione di anticorpi monoclonali", che deve essere fatta entro ottobre. "Tutti i neonati italiani hanno il diritto di avere lo stesso tipo di assistenza, le stesse possibilità di prevenzione, soprattutto per una malattia così grave che impatta in modo determinante sulla salute dei bambini più piccoli e sulle loro famiglie. Non è accettabile che solo alcuni bambini italiani possano usufruire di questa formidabile opportunità della profilassi per l'infezione, purtroppo però abbiamo 20 sanità regionali diverse". Così Luigi Orfeo, presidente della Società italiana di neonatologia (Sin), all'Adnkronos Salute fotografa la situazione nazionale a "macchia di leopardo" sulla prevenzione che potrebbe ridurre drasticamente i "15-20 mila ricoveri di neonati l'anno" causati della bronchiolite. "Come Sin e con la Società italiana di pediatria e dei medici igienisti (Siti), abbiamo partecipato al 'Calendario per la vita' che - spiega Orfeo - già dall'anno scorso chiedeva di inserire la profilassi per l'Rsv nel Piano di prevenzione nazionale, alla pari delle vaccinazioni, quindi non qualcosa da delegare alle Regioni. Questo ancora non è possibile, ma ci auguriamo che possa diventare realtà. Abbiamo poi inviato una lettera aperta al ministero della Salute e ai presidenti della Regioni, perché i tempi stringono e non è possibile che ci siano differenze di accesso alla profilassi. In questo momento non sappiamo bene come si stiano muovendo le Regioni: non possiamo fare una divisione tra Nord e Sud, perché Puglia e Campania si sono attivate come il Veneto, ma sappiamo che ancora solo poche hanno fatto le delibere. I tempi sono molto stretti: la stagione epidemica inizia ad ottobre e l'anticorpo deve essere acquistato e distribuito nei punti nascita". Ogni anno, "durante la stagione epidemica - illustra il presidente Sin - il 60% dei nuovi nati si infetta con Rsv. Non tutti manifestano la malattia, ma circa il 4%, quindi 15-20mila, sono ricoverati per questa infezione e una quota, 3-4mila, in terapia intensiva pediatrica e neonatale. Si tratta, ogni anno, di una vera emergenza e noi neonatologi siamo particolarmente coinvolti perché i più a rischio sono i bimbi nei primi mesi di vita. La malattia da virus respiratorio sinciziale si manifesta come bronchiolite, cioè come infezione delle basse vie respiratorie. Riducendosi il calibro delle vie aeree si può arrivare, in una percentuale di casi non irrilevante, a una insufficienza respiratoria, quindi alla necessità di avere una supplementazione di ossigeno, addirittura un'assistenza respiratoria". Anche se le terapie intensive neonatali sono "ben diffuse, le pediatriche sono carenti per almeno un terzo - aggiunge l'esperto - Accade così che le strutture dedicate ai neonati prematuri suppliscano alla carenza di quelle per i bambini più grandi e questa situazione può creare dei problemi proprio nei più piccoli". Gli strumenti per ridurre infezioni e ricoveri ci sono. "Da vent'anni - precisa Orfeo - usiamo anticorpi monoclonali nei neonati più a rischio, come i prematuri, ma assistiamo a un paradosso: nelle terapie intensive non ci sono i bambini più a rischio, ma quelli che nascono sani e a termine per i quali, fino a oggi, almeno in Italia, non era possibile evitare questa infezione. Oggi è cambiato tutto. Da alcuni mesi abbiamo strumenti potenti - sottolinea l'esperto - Alla vaccinazione della madre in gravidanza si è aggiunto un nuovo anticorpo da somministrare ai piccoli. Come Sin ci stiamo battendo perché l'anticorpo monoclonale a lunga durata d'azione, già approvato dalle Agenzie del farmaco europea (Ema) e italiana (Aifa), sia somministrato a tutti i neonati nella stagione epidemica da Rsv. E' comodo perché basta una iniezione intramuscolare e dà copertura per mesi: somministrato una volta a tutti i neonati si possono proteggere per la stagione" che per loro è più pericolosa. "Si potrebbe modificare la storia della malattia - osserva il presidente della Sin - riducendo in modo drastico i ricoveri, come dimostrato non solo dagli studi sperimentali, ma anche dall'esperienza di quanto già fatto in altri Paesi dove l'immunizzazione è disponibile già da un anno. In Italia l'anticorpo è stato utilizzato in Valle D'Aosta con ottimi risultati. In Spagna, Francia e Germania abbiamo già studi osservazionali", quindi sulla popolazione reale. "In Galizia, quindi in Spagna, si vede che la riduzione dei ricoveri è più del 90%. E questo - conclude - è particolarmente importante perché l'Rsv è pericoloso non solo nei più piccoli, ma anche negli anziani: eliminando la circolazione del virus si proteggono anche i più fragili". di Adnkronos   16-07-2024 - 18:46 Link copiato Commenti Leggi la Netiquette

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