What is it?

Bronchiolitis is an inflammation of the bronchioles (small passages in the lungs) usually caused by a viral infection. It usually affects children under the age of two, and peaks at age 3 – 6 months.

When does it occur most often?

There are often epidemics in the winter months, usually in June, July and August each year.

What causes it?

Whilst many viruses can cause bronchiolitis, the most common one is called respiratory syncytial virus (or RSV).

How is the virus identified?

Samples of nasal fluid may be cultured to find out what virus is present.

How is RSV transmitted?

The virus can spread in tiny drops of fluid from an infected person's nose and mouth. RSV is transmitted from person to person by sneezing or coughing, and by hand to hand. Hand washing is very important after handling your baby.

What are the symptoms of bronchiolitis?

At first, children who have bronchiolitis have a runny nose and low-grade fever, progressing to a harsh cough.

Other symptoms may include:

•    wheezing
•    rapid breathing
•    change in colour, bluish skin due to lack of oxygen
•    nasal flaring in infants
•    increased mucus production
•    difficulty feeding

How severe is it?

Bronchiolitis may range in severity from mild symptoms, which can be managed at home, to much more severe symptoms where the baby needs to be admitted to hospital.

How do we care for a baby or child with bronchiolitis in hospital?

Children, and especially babies, with a more severe form of bronchiolitis may need oxygen. Special monitors called oximeters assist in deciding when oxygen is required. They may also need a chest X-Ray.

Babies with bronchiolitis often become very tired and may not feed properly. Breast fed babies may need to be given expressed breast milk in a bottle. Babies may also need to be fed through a tube that goes up the nose and down into the stomach (N/G tube or nasogastric tube).

Some babies may need to have thick mucous secretions suctioned out of their nose and mouth. Nursing them in a sitting-up position may make them more comfortable.

Children and babies with bronchiolitis are usually isolated to lessen spread of infection to other children.

How long does it take to recover from bronchiolitis?

Most babies are in hospital for 3-7 days. Coughing may go on for 2 to 4 weeks or more. Babies who have had bronchiolitis have an increased risk of wheezing episodes later in infancy or childhood.

When should you consult your doctor?

Do so, if you notice:

•    difficulty breathing
•    increased wheezing
•    persistent coughing
•    high fever
•    difficulty feeding
•    develops a bluish colour in the skin, nails or lips

References:
Written by Hilary Durand Clinical Nurse
Cahill, M et al (Eds) (1997) Diseases, 2nd Ed, Springhouse, Pennsylvania
Isles, A, Fact sheet produced for Queensland Asthma Foundation.
Medline 03/02/2006
http://www.nlm.nih.gov/medlineplus/ency/article/000975.htm
Revised January 2006
Disclaimer: This information is intended as a guideline only and reflects the consensus of the authors after a literature review.  The sources used are believed to be reliable and in no way replace consultation with a Health Professional.