Latest update March 28th, 2024 12:59 AM
Feb 17, 2019 Dr Zulfikar Bux, Features / Columnists
By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
Bronchiolitis is swelling and mucus (cold) buildup in the smallest air passages in the lungs (bronchioles). It is usually due to a viral infection and affects up to 20% of infants, especially during the flu season. The mucus build-up blocks some of the breathing passages causing difficulty breathing. While it is often self-limiting, if left untreated, bronchiolitis can cause serious life-threatening consequences.
Today, we will highlight pertinent signs and symptoms that you should look for in your child that may suggest bronchiolitis.
WHAT CAUSES BRONCHIOLITIS?
Bronchiolitis usually affects children under the age of 2, with a peak age of 3 to 6 months. Respiratory syncytial virus (RSV) is the most common cause. More than half of all infants are exposed to this virus by their first birthday.
Other viruses that can cause bronchiolitis include:
• Adenovirus
• Influenza
• Parainfluenza
The virus is spread to infants by coming into direct contact with nose and throat fluids of someone who has the illness. This can happen when another child or an adult who has a virus:
• Sneezes or coughs nearby and tiny droplets in the air are then breathed in by the infant
• Touches toys or other objects that are then touched by the infant
Bronchiolitis occurs more often in during the flu season and rainy periods in Guyana. It is a very common reason for infants to be hospitalized during these periods.
WHAT ARE SYMPTOMS OF BRONCHIOLITIS?
Some children have few or mild symptoms.
Bronchiolitis begins as a mild upper respiratory infection. Within 2 to 3 days, the child develops more breathing problems, including wheezing and a cough.
Symptoms include:
• Bluish skin due to lack of oxygen – emergency treatment is needed
• Breathing difficulty including wheezing and shortness of breath
• Cough
• Fatigue
• Fever
• Muscles around the ribs sink in as the child tries to breathe in (called intercostal retractions)
• Infant’s nostrils get wide when breathing
• Rapid breathing
HOW IS BRONCHIOLITIS DIAGNOSED?
Your doctor will examine your child to look and listen for signs of bronchiolitis. They may hear wheezing and crackling sounds in the lungs when they listen with their stethoscope. This is usually a good indicator for bronchiolitis. Sometimes, they may order the following tests to help confirm their diagnosis of bronchiolitis:
• Blood gases
• Chest x-ray
• Culture of a sample of nasal fluid to determine the virus causing the disease.
HOW IS BRONCHIOLITIS TREATED?
The main focus of treatment is to relieve symptoms, such as difficulty breathing and wheezing. Some children may need to stay in the hospital if their breathing problems do not improve after being observed in the clinic or emergency room.
Antibiotics do not work against viral infections. Medicines that treat viruses may be used to treat very ill children.
The following measures can be taken at home to help your child:
• Have your child drink plenty of fluids. Breast milk or formula is fine for children younger than 12 months. Electrolyte drinks, such as Pedialyte, are also okay for infants.
• Have your child breathe moist (wet) air to help loosen sticky mucus. Use a humidifier to moisten the air.
• Give your child saline nose drops. Then use a nasal suction bulb to help relieve a stuffy nose.
• Be sure your child gets plenty of rest.
Do not allow anyone to smoke in the house, car, or anywhere near your child. Children who are having trouble breathing may need to stay in the hospital. There, treatment may include oxygen therapy and fluids given through a vein.
WHAT IS THE OUTLOOK LIKE FOR BRONCHIOLITIS?
Breathing often gets better by the third day and symptoms mostly clear within a week. In rare cases, pneumonia or more severe breathing problems develop.
Some children may have problems with wheezing or asthma as they get older.
WHEN SHOULD YOU VISIT A DOCTOR?
Visit a doctor or the emergency room if your child:
• Becomes extremely tired
• Has bluish colour in the skin, nails, or lips
• Starts breathing very fast
• Has a cold that suddenly worsens
• Has difficulty breathing
• Has nostril flarings or chest retractions when trying to breathe
Most cases of bronchiolitis cannot be prevented, because the viruses that cause the infection are common in the environment. Careful hand washing, especially around infants, can help prevent the spread of viruses. So your best bet is to practice good hygiene if you acquire the flu virus. This may prevent you from spreading it to an infant who unlike you can develop bronchiolitis from the virus.
THIS IDIOT TELLING GUYANA WE HAVE NO SAY IN THE 50% PROFIT SHARING AGREEMENT WE HAVE WITH EXXON.
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