Bronchiolitis refers to inflammation of the small air passageways in children's lungs. Most of the respiratory infections in children less than two years of age are caused by Respiratory Syncytial Virus or RSV. In the winter months this virus is very common and spread easily from one person to another.

Those children who seem most at risk for developing severe illness are those with underlying lung disorders such as asthma, former premature babies who may have been born with immature lungs and young infants less than a year old.

Since bronchiolitis is most often caused by the RSV virus, antibiotics are not helpful. Our treatment in most cases is purely symptomatic, help the child to be comfortable until the child's own lungs can recover.

What are the signs of bronchiolitis?

The first symptoms you may see are very much like a cold - stuffy nose, watery eyes, and a cough. As the illness progresses, you may see more severe signs such as difficulty breathing, breathing fast, using extra muscles in the chest area to help breath, or actually "wheezing" (a musical sound when the child exhales). A fever may accompany these symptoms. Many children with bronchiolitis may appear to have a "cold" and will get better without anyone noticing they have bronchiolitis. Other children may go on to more severe disease, even pneumonia. Certain children are more likely to have more severe disease with bronchiolitis.

They are those who have the following characteristics:

• a history of heart or lung disease.
• a history of prematurity with or without a history of lung disease.
• very young or small infants.
• immonosuppressed infants.

How do you get bronchiolitis?

The germs that cause bronchiolitis are spread from person to person by coming into contact with respiratory secretions. A person may either touch these secretions on another person or object or pick up droplets when someone coughs or sneezes. Both children and adults who have colds and runny noses can spread the virus to other people they contact.

To prevent the spread of these germs, do the following:

• do not share drinking glasses.
• teach your children to cover their nose and mouth when they cough or sneeze.
• wash hands frequently, especially when your child has a cold and always after coughing and sneezing.

How do you treat bronchiolitis?

Most children with bronchiolitis do not need to be hospitalized and may be managed at home. Some measures that help include:

• increase your child's intake of fluid.
• increase the humidity in your child's room.
• keep your child's head above the level of his or her body to promote drainage from the upper respiratory passages.
• avoid smoke.
• treat fever with acetaminophen.
• keep your child comfortable.
• it may benefit your child to give smaller, more frequent feedings while the coughing is at its peak.

If your child appears to have underlying airway problems, we may put your child on medication to help expand his or her airways or even an anti-inflammatory medicine. Those children who are admitted to the hospital with severe bronchiolitis receive oxygen to make them more comfortable as well as breathing treatments to help their lungs recover from the illness. An intravenous line (IV) will give your child fluid and some calories until he or she recovers. Because the spread of bronchiolitis is easy, your child will be confined to his or her own room or share a room with another child with bronchiolitis until your child is discharged.