Bronchiolitis is a childhood disease that affects the lungs. It occurs when a virus enters the breathing system. The virus causes the tiny airways in the lungs to become swollen. As a result, a thick fluid called mucus collects in the airways. This makes it hard for air to flow freely in the lungs.
Usually, the infection goes away after 7-10 days. Some children show very mild symptoms. In others, the disease can be severe. Older children are less at risk. If they get bronchiolitis, they don’t get as sick as younger children.
This infection is caused by several kinds of viruses. It easily spreads from person to person in the same way a common cold]]> does. This most often happens when an infected person coughs or sneezes. Droplets of moisture are released into the air. When a noninfected person breathes the air they can become infected.
Bronchiolitis can affect anyone, but it most often strikes:
- Children under the age of two, especially between 3-6 months old
- During the winter months
Adults most at risk are those who are:
- Exposed to toxic fumes
Children most at risk are those who:
- Were never breastfed
- Were born prematurely]]>
- Are exposed to tobacco smoke
- Are often in groups of children (as in day care) or live in crowded conditions
Symptoms of bronchiolitis occur in two stages:
During the first 2-3 days the child will probably have a:
- Runny or stuffy nose
- Slight fever
During the next 2-3 days, the symptoms increase to include:
- Cough (dry)
- Red eyes
- Fast rate of breathing
- Difficulty breathing
- Wheezing (making a whistling noise during breathing)
- Bluish color in the skin, especially around the lips or nails
- Poor feeding
To diagnose bronchiolitis, the doctor may do one or more of the following:
- Listen to the child’s lungs to check for abnormal breathing, such as wheezing
- Chest x-ray]]> to check for swelling in the airways and signs of ]]>pneumonia]]> (severe case)
- Sample mucus from nose or throat to test for the virus that may be causing the infection
- Blood test to determine the level of oxygen in the blood
- Blood test for complete blood count
There is no medication to cure viral infections. Doctors sometimes prescribe corticosteroids. These may help to reduce swelling and mucus in the airways. But, there is limited evidence showing its benefits.
This infection usually clears on its own after a week or ten days. There are several ways to make the child more comfortable while he or she is experiencing symptoms:
- Have the child drink clear liquids.
- Use a vaporizer in the bedroom.
- When the child is coughing or having difficulty breathing, steam the bathroom using hot water from the shower. Sit in there with the child.
- Advise smoking parents to not smoke in front of child.
- Use acetaminophen]]> (eg, Children’s or Infant’s Tylenol) if a fever is present.
In severe cases, medical treatment may be needed. The doctor will check for ]]>dehydration]]> and pneumonia. The doctor will also make sure the child is getting enough oxygen. Medications may be as well.
Call the doctor if the child:
- Is vomiting and can’t keep liquids down
- Is breathing very fast (more than 40 breaths in one minute)
- Has bluish skin, especially around the lips or on the fingertips
- Has to sit up to breathe
- Was born prematurely or has a history of heart disease
- Appears dehydrated
Bronchiolitis can spread easily from one person to another. Children should be kept home until they are well to prevent giving the infection to others. There is no vaccine to prevent bronchiolitis. There are medications that may lessen the risk of infection by respiratory syncytial virus (RSV)]]> . RSV is a virus which causes more than half of all cases of bronchiolitis. This medication is usually given to high-risk babies.
]]>Proper handwashing]]> habits can help to prevent the spread of illness. Make sure to wash your hands before touching a baby or after being in contact with an infected one.
American Academy of Family Physicians
National Library of Medicine and the National Institutes of Health
BC Children’s Hospital
The Canadian Lung Association
The Canadian Paediatric Society
Beers MH, Fletcher AJ, Jones TV, et al, eds. The Merck Manual of Medical Information . 2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003.
Bronchiolitis. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000975.htm . Accessed August 4, 2005.
Bronchiolitis and your child. American Academy of Family Physicians website. Available at: http://www.familydoctor.org . Accessed August 4, 2005.
Gadomski AM, Bhasale aL: Bronchodilators for bronchiolitis. Cochrane Database Syst Rev 2006 :CD001266.
Smyth RL, Openshaw PJ. Bronchiolitis. Lancet. 2006;368:312-322.
Steiner RWP. Treating acute bronchiolitis associated with RSV. Am Fam Physician. 2004;69:325-330.
8/10/2007 according to the following study, as cited by DynaMed's Systematic Literature Surveillance : Corneli HM, Zorc JJ, Majahan P, et al. A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis. N Engl J Med. 2007;357:331-339.
2/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Panickar J, Lakhanpaul M, Lambert PC, et al. Oral prednisolone for preschool children with acute virus-induced wheezing. N Engl J Med. 2009;360:329-338.
Last reviewed September 2009 by ]]>Christine Colpitts, CRT, MA]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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