RSV bronchiolitis — ‘Tis the Season for Wheezin’
Bronchiolitis is an infection of the lower respiratory tract, most commonly caused by RSV (respiratory syncytial virus). Seasonal outbreaks of the infection typically occur from November through April in the northern hemisphere and from May through September in the southern hemisphere. By 2 years of age, almost all children have been infected by RSV; unfortunately, long-lasting immunity doesn’t occur after infection, and reinfection is common, but less severe.
Initially, RSV will present with typical cold symptoms – fever, runny nose, watery eyes, and cough, usually for 1-2 days. The infection then presents with lower airway involvement, characterized by wheezing and rapid breathing (tachypnea). A child with more severe breathing problems may present with flaring of nostrils, rib pulling (retractions), ‘crackles’, (rales), prolonged exhaling, and even breathing cessation (apnea). Many children who have RSV bronchiolitis will continue to have recurrent wheezing for years to come.
Care is usually supportive, as it has been shown that medications typically used to treat wheezing such as albuterol and steroids are ineffective at treating bronchiolitis. Parents can help the baby to breathe easier by keeping the baby’s nasal passage as clear as possible with saline drops and a nasal aspirator. A humidifier at the side of the crib can also help thin airway secretions. Feeding is another area of concern for babies with bronchiolitis, as airway congestion and narrowing can make it even more difficult for the baby to feed properly.
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