What is bronchiolitis?  Bronchiolitis is the inflammation of the bronchioles (small caliber airways in the chest).  The cause is mostly viral, and the most common virus that cause bronchiolitis is RSV
(respiratory syncytial virus ). 

When is RSV season?  RSV season is from late October to beginning of April. 
(Think of it as RSV season when Major League Baseball season is over.)

How is RSV spread?  RSV is mainly spread through coughing droplets.  So remember to wash your hands to decrease the chance of spread.

What are the clinical findings of RSV?  RSV usually initiates as typical cold symptoms, running nose and coughing.  A few days later, wheezing and difficulty breathing may ensue.  Children less than 2 years of age are more likely to develop difficulty breathing and wheezing because their airways are smaller to begin with-- so any additional swelling of the airways may result in wheezing and shortness of breath.

Is bronchiolitis the same as asthma?  The answer to this is no.  Bronchiolitis is caused by viruses.  Asthma has many triggers.  Both have airway inflammation.  Both have increased mucous production.  Coughing will protect the airway by helping to remove the mucous, therefore, NEVER GIVE COUGH SUPPRESSANTS TO A CHILD WITH BRONCHIOLITIS.  In contrast to asthma, there is no airway smooth muscle constriction (bronchoconstriction) of the airways in true bronchiolitis. 

How do I treat bronchiolitis?  Medication is not routinely used for bronchiolitis.  The treatment is mainly supportive (e.g., providing supplemental humidified oxygen when needed, room humidifier, normal saline nasal drops and bulb suctioning of nasal mucous).  The airway inflammation and swelling will eventually go down (usually after day 5 of illness).  Asthma medication is controversial and may not help (unless there is underlying reactive airway [asthma-like] component to the patient). Steroids show little benefit and may actually prolong the clinical course. 

Some physicians may still give nebulized inhaled bronchodilators, as used in asthmatics because of the following:

1. Unsure of an underlying reactive airway component, as triggered by the viral infection.
2. Humidity from the nebulized solution will help loosen lower airway secretions to ease coughing and breathing.

There is an RSV immunoglobulin (antibody) vaccine (palivizumab [Synagis]) given to high risk patients (premature children and children with chronic lung disease).  This shot is to prevent any severe symptoms from an RSV infection.  This is indicated for children less than 2 years of age and is given monthly, usually between the months of October to April. 

If you suspect that your child has bronchiolitis, then please have him/her evaluated by your healthcare professional.

1-2-3 Pediatrics
2380 S Eola Rd, Suite #102, Aurora, IL. 60503
(630) 978-7337