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Bronchiolitis/RSV - Read the facts

Have you heard of this life threatening illness, and do you understand what it is?

The chances are, you will not.

The condition is a severe lung disease which primarily affects babies and children, and is the most common single cause of infantile hospital admissions in the UK. Yet according to a MORI poll commissioned by Action Research, most people are unaware of the illness. Revealed to coincide with a new campaign launch, the results found that 62% of people have never heard of bronchiolitis.

Only 4% of people who were aware of it correctly identified it as a disease that affects babies and children. And 1 in 10 confused it with the better-known lung infection, bronchitis.

Bronchiolitis: what is it?

Bronchiolitis is a respiratory disease in which the lower airways in the lungs become inflamed and swollen. The majority of cases are harmless and cause only mild symptoms in affected youngsters. But it can lead to life-threatening chest complications in others.

Simon Moore, Chief Executive of Action Research, said: 'Each year in the UK alone, bronchiolitis results in the hospitalisation of some 20,000 infants under one year old, and it's a serious illness these babies could do without. 'As a seasonal disease, most cases peak between November and March. With this period imminent, Action Research has launched an awareness campaign to raise its profile, and announced a new research study designed to help give these babies a better start in life.'

What causes bronchiolitis?

A virus called RSV (Respiratory Syncytial Virus) is the most common cause of bronchiolitis. It is highly contagious and causes epidemics of bronchiolitis every winter (with a seasonal period between October and March). It causes the bronchioles - the tiny air passages deep in the lungs - to become inflamed and clogged up with mucus and dead infected cells. This prevents air from moving in and out of the lungs, causing breathing problems and sometimes damaging the lung tissues.

Young babies are especially vulnerable, partly because their airways are so much smaller than the airways in older children. Babies born prematurely or with a congenital heart problem are more at risk.

What are the signs and symptoms?

In the early stages, the infection is limited to the upper airways, and babies may have symptoms similar to a cold, such as fever, runny nose and mild cough. Ear infections are also common. Bronchiolitis occurs when the viral infection spreads to the lung. The child's breathing may become quicker and shallower, and may sound wheezy. He/she may also feed poorly and be more tired than usual. In severe cases a child may not be able to feed at all and will have a bluish tinge to the lips or complexion caused by oxygen shortage.

What should you do?

Bronchiolitis can be very serious, so it is important that you seek medical help if you are concerned. If your baby has breathing difficulties, he/she may need to be admitted to hospital. Contact your GP or call NHS Direct on 0845 4647.

What treatment is available?

At the moment, there is no effective cure for bronchiolitis. A child with sever bronchiolitis may need to go to hospital to be given help with their breathing, including oxygen. If the infant is dehydrated, extra fluids may need to be given either through a tube in the nose into the stomach or via an intravenous drip.

What can you do to prevent it?

RSV is spread by large droplets by direct or very close contact. If your child is infected with RSV, the best way to prevent the spread of the virus to others is to take extra care when washing and drying your hands.

What are the long term implications?

Most children who get bronchiolitis make a full recovery, but some cough for many weeks after the infection. Children who get bronchiolitis also appear to have an increased risk of asthma in later life. In most cases the child outgrows the problem with time.

What's the difference between bronchiolitis and bronchitis?

Bronchiolitis should not be confused with the better known bronchitis, which is an infection of the larger upper airway in the lung (the bronchi), and mostly affects adults, particularly those who smoke.

Information courtesy of www.actionresearch.org.uk with permission.


My experiences

When my first son, now age 10, was 5 weeks old. He appeared to get a bad cold. He was coughing and snuffly, and appeared to have problems feeding. I took him to see my GP, who informed me he had a virus, and he'd just fight it for himself.

Over the next day or so, Aaron started feeding less until he was refusing virtually every feed, so I called out the out of hours doctor, who admitted Aaron to hospital straightaway. That was when I first heard the word "bronchiolitis" and was told a little about it. When he went into hospital, he was dehydrated, was recessing badly in his throat, chest and ribs. He was immediately put in an oxygen headbox, and put on tube feeds. They used suction to clear the mucus, and also physio to try and loosen it. Luckily, after a week in hospital, he got the all clear and came home with no adverse effects.

Six years later, I gave birth to triplets, Jasper, Eleanor and Nathaniel, 7 weeks early. They were very small when born - 3lb 1/2oz, 2lb4oz and 3lb1oz. They were all healthy, and as they were born in March, I thought we'd escaped bronchiolitis "season". I spoke too soon. In mid December Eleanor started showing symptoms of the virus. I immediately recognized it for what it was and called the out of hours doctor and went to the surgery to see him. He told me that she had a virus, and to take her home. I pointed out to him that she was barely feeding, recessing very badly, high temperature that paracetamol wasn't reducing. Couple that with the fact that she still weighed only 13lbs at 8 months, I was not happy to take her home. He reluctantly rang the children's' ward at the local hospital and was told to inform me to bring her in immediately.

Ellie was put on tube feeding straightaway - luckily she wasn't too badly dehydrated, so that was all the treatment she required, plus ibuprofen to bring her temperature down.

Two days later, I took Jasper and Nathaniel straight to the ward where Ellie was, as they were displaying exactly the same symptoms. They were both admitted and put on oxygen using nasal prongs and tube fed, as well as the ibuprofen. Unfortunately, Nathaniel didn't start to improve, so was taken off all milk feeds and put onto intravenous fluids, plus antibiotics as he'd developed pneumonia. He was also put into a headbox with humid oxygen in there. He was a very poorly boy.

Luckily, they all turned the corner, and came home the week before Christmas.

Now, it does appear that they have a tendency towards bronchiolitis, as they have all had it every winter. They're now 3 1/2, and Eleanor is just recovering again. The boys, up to now, are okay. Their second winter, Eleanor and Nathaniel ended up back in hospital for 5 days each, Jasper was okay. They should, in time, grow out of this.

I consider myself to be lucky, in that my children survived without too many lasting effects, but there are children who are not so lucky, and this is why I feel raising awareness of this disease can only be a good thing.

Factsheets are available free of charge by sending a stamped self addressed envelope to: Bronchiolitis leaflet, Action Research, Vincent House, North Parade, Horsham, West Sussex, RH12 2DP, or by visiting: www.actionresearch.org.uk

Please click on the link below to see how you can help in further research of bronchiolitis.

www.actionresearch.org.uk/camp/bronch.html

Article presented by Bernadette Kean, November 2002