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Bronchitis in Infants

Bronchiolitis is a respiratory illness that affects the lower airway. It is an inflammation of the smaller airways caused by infection. The most common infections are viral and include RSV (respiratory syncitial virus), parainfluenza viruses, adenovirus, and rhinovirus. RSV causes most cases. It is usually seen in the winter months (November through April) and usually affects children under the age of 3 years.

Bronchiolitis is characterized by runny nose, cough, wheezing, low grade fever, and fast breathing. It is worst the first time a child gets the illness, with subsequent infections usually being milder, consisting of mainly runny eyes and nose, and occasionally mild wheezing. It is most dangerous in young infants under the age of 3 months and those with chronic lung or heart disease and premature babies (less than 35 weeks gestation).

Treatment for the vast majority of children consists of saline nose drops and close observation at home. In more severe cases, it may be helpful to use bronchodilator medicines such as albuterol in a syrup or mist form. Your physician may try a treatment in the office, and, if this helps, will give you a prescription. The vast majority of children are treated at home, occasionally it may be necessary to be admitted to the hospital for closer observation in the more severe cases and in young infants.

Infants and children with underlying lung conditions or premature babies should be watched very closely and may need hospitalization. The newest preventive treatment available for these children who are 2 years old or younger, is Synagis (RSV-IMIG). This is a monoclonal antibody treatment given in the muscle, that is specific only for preventing bronchiolitis caused by the RSV virus. It is usually given in the doctor’s office once a month, starting in November and ending in April. Remember that this is a prophylactic treatment, meaning that it is given in hopes of preventing disease, not for treatment once illness has occurred.

There have been studies reporting the recurrence of wheezing in children who have had bronchiolitis. It has been reported that approximately 50% will wheeze again, usually though, only until the age of 2 to 3 years. A smaller percentage may go on to have asthma.