Bronchiolitis is one of the most common inflammatory conditions of the bronchioles, the smallest airway branches of respiratory tree. This inflammation causes the bronchioles to expand and release mucus, which accumulates in the lumen of these tubes and eventually blocks the airway. This narrowed passage for air causes a difficult breathing.
Bronchiolitis is an infection caused by a virus. The Respiratory syncytial virus (RSV) is the most prevalent causing virus. The other causes may include adenovirus, influenza and parainfluenza viruses. It is most frequent in children under the age of two, mainly between the ages of three and six months. It is a seasonal infection that is more in the fall and winter months and more than one episode can occur in one season.
Any baby below the age of 6 months is at risk of acquiring the infection. This is because the lungs and the disease fighting defenses called the immune system are not mature enough in the early months of life. More boys than girls develop the infection. Other risk factors include babies who are not breast-fed, those who are born premature, those who are sent to a child care where other children may have the infection, or having a sibling who visits school or a child care and brings home the infection. Babies with an underlying medical problem in the heart or lung and those with a weak immune system are more prone to the infection.
Symptoms
Bronchiolitis can begin as a small respiratory ailment with symptoms comparable to a cold. The child may have a stuffy or runny nose, and a low-grade fever may or may not be present. A dry and irritating cough may be present. After around a week, the disease may progress to worsen the symptoms. The child may develop a rapid and more difficult breathing, associated with wheezing (whistling sound). The heart rate may also go up. The illness usually resolves in a week or two.
In others, the infection may progress to a florid disease with increasingly labored breathing with flaring of nostrils, fatigue, and a sick child. With each effort to breathe, the baby grows irritated and may cry consistently. The baby may turn pale, and then blue. This indicates a serious lack of oxygenation. The infant may become dehydrated and could suffer from acute respiratory failure. These situations necessitate hospitalization and emergency management.
Child care
The child should be offered loving and comforting care. For easier breathing and wider airways, the newborn should be carried upright. Feed breast milk on a regular basis. Fluids such as juices and water can be given in little, regular sips. To cleanse the passageways, saline nasal drops, which are available over-the-counter, can be injected into each nostril. After the drips have been instilled, the baby should be placed back upright. The nostrils may be cleared with a small suction bulb taking care not to push the suction nozzle too far into the nose. If the child develops a slight fever, over-the-counter drops of medicines like paracetamol may help. The room where the child is cared for should be kept clean, smoke-free, and at a pleasant temperature. The air should be sufficiently humidified. Dry air irritates the nasal passages. Therefore, a humidifier or vaporizer maybe used to relieve coughing and alleviate congestion in the nose and respiratory passages. The child should be allowed to take plenty of rest and should be closely watched for any worsening of respiratory distress.
If the child becomes excessively unwell and irritated, he or she should be taken to a doctor or a healthcare practitioner. Cyanosis, or bluish coloring of the skin, lips, and fingers, is a warning indication. Other symptoms that require medical treatment include a severe cough, quick shallow breathing, retraction of the chest wall during breathing, and flaring of the nostrils. A child who is drowsy, does not listen to instructions, and consistently refuses to drink should be taken to the doctor.
Diagnosis
The doctor may inquire about the severity and length of symptoms, as well as any illnesses that predispose to bronchiolitis. Furthermore, the doctor may inquire about meal patterns and any vomiting, as well as look for indicators of dehydration such as sunken skin, dry lips, and decreased urination. When necessary, the doctor may order a chest X-ray to examine the lungs and rule out any other disorders. A sample of the mucus can be taken using a swab or a suction catheter and examined in a laboratory for the causative viruses. Blood tests may be done for levels of oxygen in the blood and for the count of white blood cells (WBCs). The WBCs are commonly increased in situations where the body fights an infection.
Treatment
The doctor may offer help and advice to help the child feel better. If an accompanying bacterial infection is suspected, the doctor may prescribe a course of antibiotics. Antiviral medications such as ribavarin may be administered in the most severe cases, but not always. If the child is critically ill, the doctor may recommend hospitalization. The child is then provided with humidified oxygen through a mask, as well as drinks to keep him hydrated. Fluids may be administered via a superficial blood vessel.
Bronchiolitis is contagious
Bronchiolitis is contagious. The infection may spread from one person to another. This is why children in day care centers are more likely to get the infection. Families who live in unhygienic and overcrowded environments are more vulnerable to infection. Children, on the other hand, can be protected with basic precautions. If one has a cold, the hands should be washed thoroughly with soap and water before the baby is touched. A face mask may be of help to prevent spread of infection. A sick child should be kept at home rather than sent to day care. Cleanliness will help to keep the causative viruses at bay. Particular attention should be paid to keeping the kitchen and bathrooms clean and disinfected. Never reuse tissues used to wipe the baby’s nose and mouth. The baby’s bottles, glasses, or sippers should not be shared with anyone. Hands should be cleansed frequently, and a sanitizer should be brought with you when you leave the house. There are no available vaccinations to prevent the infection. Some children at high risk may be advised to have palivizumab injections once a month during the peak winter season, when infection is more common. This may last from November to March.
Outlook
When your infant has bronchiolitis, he or she may become quite uncomfortable. As a result, provide your infant the best possible care. Proper care can help to fight an episode of infection and precaution can prevent the spread of infection. Timely medical help is important in bronchiolitis.
