Bronchiolitis

What is bronchiolitis?

Bronchiolitis is a viral infection that affects the small branches of the airways of infants and small toddlers. Breaking down the word... "Bronchiol-" small branch of the airway within the lung, and "-itis" inflammation of.

The bronchiolitis season runs from winter through spring and varies each year as to when it peaks. Generally, November to March or even early April is the peak season, with an emphasis toward the spring months.

What are the symptoms of bronchiolitis?

The symptoms can vary from what seems like a bad runny nose to significant respiratory distress requiring hospitalization. Children with significant bronchiolitis may wheeze, but the wheezing does not respond to breathing treatments like it would in an asthmatic child. Some of the symptoms of significant respiratory distress include quick shallow breathing, abdominal "belly" breathing, and gasping.

What causes bronchiolitis?

Bronchiolitis is caused by numerous viruses. One of the common viruses that has been isolated and can be tested for is RSV "respiratory syncytial virus".

How do you treat bronchiolitis?

Unfortunately, only symptomatic care can be used. There are no medicines currently available to fight the infection because it is viral. The goal of treatment is to support the child until the virus has run its course. There is a vaccine available to protect against RSV. It is called Synagis (palivizumab), and is a passive immunization. Because of this, it must be given on a monthly basis through the bronchiolitis season and is only given to high risk children mostly due to cost (upwards of $1,000 per dose).

Who gets bronchiolitis?

Infants and young toddlers can get the disease. Those whom are at extremely high risk include very young children, former premature infants, infants with a history of breathing problems, and any other medically complicated infant.

What is the course of the disease?

Most infants will do ok in the outpatient setting, with the goal of therapy being nasal suction and comfort care. In certain situations the secretions can overwhelm a child, and closer monitoring in the hospital may be required. In the hospital, a respiratory therapist will provide frequent suctioning and oxygen as needed. Despite good care a small percentage of children will progress to respiratory failure and need to be put on a ventilator (breathing machine) for a period of time.

Are there any long term problems?

Not usually. There have been some studies which have shown the children who have RSV bronchiolitis have a higher incidence of Reactive Airway Disease.

JDMD 1/20/01, revised 3/7/01, 2/20/02