Bronchiolitis is a viral infection that is localized in the lungs. RSV, respiratory syncytial virus, is the most
common cause of bronchiolitis. The virus can infect children of all ages but it is most serious in young children and infants. In adults an RSV infection is similar to the common cold. In children it causes them to wheeze. A child can have bronchiolitis and not have RSV. Other viruses that cause bronchiolitis include the rhinoviruses, which are known for causing the common cold. The treatment is essentially the same for both although a child with RSV is typically followed more closely.
Symptoms
Children tend to have both cold symptoms and respiratory symptoms such as wheezing. Usually RSV and bronchiolitis start out with a cough, fever, and runny nose. Within a few days this will progress to wheezing, rapid breathing with possible difficulty breathing. Some infants and children may be fussier and not want to eat as much. Occasionally, you can hear your child wheeze or feel the congestion in his/her chest with your hand. If RSV becomes more serious, children may breathe at a very rapid rate of over 60 breathes per minute may pull their chest in to breathe. If your child ever seems to have a lot of difficulty breathing, is pulling the chest in, or is flaring the nostrils with each breath, please take him/her to the emergency room.
Wheezing
Children with RSV or bronchiolitis wheeze because the virus causes irritation, swelling, and mucus production in the small airways of the lungs. The mucus gets trapped in the airways causing reduced airflow to the lowest parts of the lungs. Wheezing is inflammation in the lungs. With each breath, this mucus moves and can also cause popping or crackling noises.
Cause
Bronchiolitis and RSV are transmitted much like the common cold. The RSV virus itself can live on surfaces for many hours and up to 30 minutes on hands. RSV is most common in the winter and early spring months. It is very
common for the virus to be passed from adults to children and passed from child to child in daycare. Often we are unsure of where the child contracted the virus, because it is so easily transmitted. Your child can be tested to see if they have RSV by a nasal swab in the office. The results of the swab are usually available within 15 minutes.
Treatment
In order to prevent the child from having too much difficulty breathing, nebulizer treatments are given. These are breathing treatments with a medicine your child breathes in to open up the airways. The most commonly used medicine is Albuterol. This is a ‘bronchodilator' which will help your child to breathe better. Most treatments are done every 4-6 hours for several days. Your child may actually cough more after using Albuterol, because the airways are now opened up. Never use cough suppressants in a child with bronchiolitis or RSV. It is important that your child is able to cough up the mucus in the lungs. If necessary, we may occasionally use a short-term course of low-dose steroids for children that are not improving with only Albuterol. There are no antibiotics to treat bronchiolitis or RSV because it is not a bacterial infection.
