Bronchiolitis-Respiratory Syncytial Virus

Every year many babies develop bronchiolitis and some so badly, that they have to be admitted to hospital. Bronchiolitis is an infection of the bronchioles, or small lung airways (tubes).

What causes bronchiolitis?

The Respiratory Syncytial Virus is known commonly as RSV causes this infection, which usually develops during the winter or early spring. RSV usually causes the typical bronchiolitis symptoms described below, in children less than 2 years of age. In older people, it usually causes infections that resemble the common cold. The typical symptoms of bronchiolitis in babies include:

  • Cough
  • Wheezing
  • Difficulty Breathing
  • Production of large amounts of secretions
  • Decrease feeding or drinking

If your baby has any of the above symptoms you should see your doctor immediately

Because bronchiolitis is caused by a virus, antibiotics are not effective in treating RSV. An antiviral medication (ribavirin) has been tested. Because of its potential side effects and impracticality of use, this medication is not generally used. The treatment is therefore supportive and depends on the severity of the infection. Most infants with RSV bronchiolitis cough and/or wheeze a bit, but in general feed well and do not need oxygen or any other treatment. Within a few days, their infection clears on its own.

More severe cases of bronchiolitis

Some babies may have enough discomfort and difficulty from the wheezing and secretions that they may need extra oxygen or even the administration of Ventolin or salbutamol (a bronchodilator used in asthma). Also, if they cannot drink enough they may require intravenous fluids. One of the most important aspects of treatment is helping these babies get rid of their excessive secretions and this usually requires hospitalization. Rarely, in very severe cases, some babies are actually placed on respirators to help them breathe.

Are any babies at high risk?

Premature babies and those with chronic respiratory or cardiac problems are at higher risk for developing severe bronchiolitis. Because of this, a special vaccine has been developed for these high-risk babies that offer protection against RSV. If you have a baby who is at high risk for RSV, you should speak to your doctor about it.

Can bronchiolitis develop into asthma?

The issue of RSV becoming asthma is potentially confusing because the symptoms of bronchiolitis are the same as those of asthma. Asthma is defined as a condition of recurrent episodes of wheezing and/or cough and/or difficulty breathing in a child with no other lung problems or conditions. There is some uncertainty as to the relationship between RSV infection and subsequent development of asthma; some experts suggest that children who have an inherited allergic or asthma tendency are more prone to RSV infections, while others say that RSV may trigger subsequent asthma. In any case, if a child seems to be getting recurrent episodes, asthma would be the more likely cause and not recurrent bronchiolitis. However, if a child has had only one isolated RSV episode and nothing else later on, then by definition this is not asthma.

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Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.