A lung infection that usually happens in young children and infants and causes swelling and irritation in the small airways of the lung is called bronchiolitis. This is a common lung infection that may also cause a buildup of mucus in the airways. Small airways of the lungs are called bronchioles. In most cases, this lung condition happens due to a virus.
Commonly, this condition begins with symptoms very similar to a common cold, but when it worsens, it may cause cough, a whistling sound when breathing out (also known as wheezing), and breathing problems. While most children and infants experience symptoms for 1 to 2 weeks, sometimes, the symptoms may last longer.
Commonly, this condition is treated with home remedies. In most severe cases, hospitalization is required.
Symptoms
When the symptoms appear, they are similar to a common cold. These include:
- Runny or stuffy nose
- Cough
- A slight fever
If the condition worsens, children and infants may experience trouble breathing, wheezing, and other symptoms. In addition, most children with bronchiolitis also have otitis media (an ear infection).
It is recommended to see a doctor right away if your child or infant experiences severe symptoms, especially if it is younger than 12 weeks of age or have other risk factors for bronchiolitis. These include premature birth, heart conditions, and others.
Seek emergency care if any of the following symptoms occur. For example:
- Blue or gray skin, lips, and fingernails are often caused by decreased oxygen levels
- Persistent cry
- Breathing problems (including fast breathing, shallow breathing, and others)
- Wheezing
- Weakness
- Fatigue (extreme tiredness)
Causes
This lung infection usually occurs due to a virus that affects the bronchioles. The infection often causes irritation and swelling of the bronchioles. Once the condition occurs, the mucus starts to collect in these small airways of the lungs, which makes it challenging for the air to flow.
The most common virus that causes bronchiolitis is called respiratory syncytial virus (RSV). It often infects approximately all children younger than 2 years of age. Commonly, RSV outbreaks happen during colder months of the year and sometimes in the rainy season. Generally, a person may become infected with this virus multiple times. Additionally, bronchiolitis may happen due to other viruses as well (including those that cause the flu or the common cold).
The virus that causes this condition usually spreads easily among people. You may get it from air droplets when an infected person coughs, sneezes, or talks. Therefore, you should not share or touch personal items with an infected person. These include dishes, doorknobs, towels, toys, and others. In most cases, the virus enters the body when you touch infected objects and then your eyes, nose, or mouth, or inhale infected air droplets.
Risk Factors
Usually, bronchiolitis occurs in children under 2 years old. An increased risk of developing this lung infection have infants younger than 3 months because their lungs cannot fight infections and are not completely developed. However, adults may also develop this infection. Check below some factors that could elevate your risk of developing bronchiolitis:
- Premature birth (being born too early)
- Lung or heart conditions
- Weakened immune system
- Secondhand smoke
- Direct contact with a lot of other children
- Spend time in crowded places
- Have siblings who may bring home the infection from school
What Are The Potential Complications of Bronchiolitis?
Infants and children with bronchiolitis may experience some complications, especially if they develop a severe form of the infection. Check below some examples:
- Reduced oxygen levels in the blood
- Pauses in breathing that often occur in babies under 2 months of age or being born too early
- Inability to drink liquids, which often leads to dehydration
- Respiratory failure
In general, hospitalization is required if any of the previous complications occur. For instance, to improve breathing, your child may need a tube that is guided into the windpipe.
How to Prevent Bronchiolitis?
One of the best ways to prevent this condition is regular hand washing. It is very important, especially before touching the baby or if you have a cold, flu, or other conditions that can spread easily. You should also wear a face mask before getting in contact with the baby.
However, once your child develops bronchiolitis, it is advised to keep him/her at home until the infection goes away because it helps to prevent the spread of the virus to others. Check below for other tips that may help prevent the infection:
- Limit contact with those who have a fever or cold – You should avoid contact with an infected person with your child, especially if it is born prematurely.
- Clean and disinfect surfaces – Regularly clean and disinfect surfaces and items, especially those that were touched by other people (such as doorknobs and toys).
- Regularly wash your hands – It is advised to wash your hands for at least 20 seconds with warm water and soap each time you come in contact with your child. When it is not possible, you should clean your hands with a hand sanitizer with at least 60% alcohol.
- Cover your mouth when you cough or sneeze – Use a tissue to cover your mouth and nose while coughing or sneezing. Thereafter, discard the tissue. When a tissue is not available, use your elbow to cover the nose and mouth.
- Do not share glasses – It is not recommended to share glasses with other people, especially if a family member or loved one is ill.
- Breastfeed – As per studies, respiratory infections occur less commonly in breastfed babies.
Vaccination
RSV (respiratory syncytial virus) is the most common cause of bronchiolitis and pneumonia in children under 1 year old in the U.S. However, there are two options for immunization that help children and infants from developing a severe form of lung infection. Both options are recommended by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and others. For example:
Nirsevimab
This is an antibody product that is often given in a single dose either before or during RSV season. It can be used in newborn babies and those younger than 8 months of age. Generally, this shot is given to children and infants from November to March, which is the RSV season in the U.S.
This vaccine should be given to children from 8 months through 19 months of age who are at increased risk of severe RSV infection. Check below some high-risk diseases:
- Chronic lung disease from being born prematurely
- Severe weakened immune system
- Severe cystic fibrosis
Rarely, Nirsevimab is not an option, and doctors recommend another antibody product known as Palivizumab. The only difference is that Palivizumab is given each month during RSV season, while Nirsevimab is given in a single shot only.
Vaccination during Pregnancy
There is a vaccine approved by the FDA for pregnant women. It is called Abrysvo, and it helps prevent RSV in infants from birth through 6 months of age.
In addition, there are other viruses that may cause bronchiolitis, such as COVID-19, influenza, or the flu.
Diagnosis
This lung infection is often diagnosed by listening to the child’s lungs with a stethoscope. However, doctors may perform certain tests when your child is at increased risk of developing a severe form of the infection. These include:
- Chest X-ray – This imaging test may identify pneumonia.
- Viral testing – During this test, doctors will get a sample of mucus from the child’s nose and then test it in the laboratory to check for the viruses that cause bronchiolitis.
- Blood tests – Doctors perform these tests to check for white blood cell count. Usually, an increased level of white blood cells indicates an infection. A blood test may also show reduced oxygen levels in the body.
Healthcare professionals may check for dehydration symptoms, especially if the child does not drink or eat, or vomits. The most common symptoms of dehydration include fatigue, little or no urine, and dry mouth and skin.
Treatment
Commonly, the symptoms of bronchiolitis last for 1 to 2 weeks. Furthermore, most babies are treated at home, but it is important to check if breathing is not getting worse. These include shortness of breath, inability to speak, persistent crying, or wheezing during breathing.
You should know that the condition is caused by viruses. Therefore, antibiotics cannot be used to treat bronchiolitis. Doctors prescribe antibiotics when the condition or infection is caused by bacteria. Some children develop pneumonia or otitis media, which are caused by bacteria. In such cases, doctors usually prescribe antibiotics.
Physicians may also prescribe bronchodilators. These are specific medicines used to open the airways. Moreover, oral corticosteroids are also recommended by doctors to loosen the mucus that builds up in the airways.
Home Remedies
The following tips may help your child improve the symptoms and make him/her feel more comfortable. Examples include:
- Humidify the air
- Make sure your child drinks enough liquids
- Try saline nose drops
- Give your child over-the-counter (OTC) pain relievers when needed
- Avoid secondhand smoke
In any case, before using any OTC or prescription medicines, consult with your doctor. Otherwise, it may lead to unpleasant results.
Frequently Asked Questions
How contagious is bronchiolitis?
This is a very contagious lung infection that spreads through direct contact with an infected person. The virus may enter the body even when you touch infected surfaces or objects and then touch your nose, mouth, or eyes.
How long does bronchiolitis last?
Usually, this condition goes away within one week, but in some cases, it may last slightly longer.
Can bronchiolitis turn into pneumonia?
In rare cases, this lung infection may turn into pneumonia. This is another lung infection that causes the air sacs called alveoli to swell. As a result, it causes trouble breathing. Ask your healthcare professional if you have additional questions.
