Thursday, November 27, 2014
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When colds become more serious

The viruses that cause colds in children and adults cause a completely different and more serious disease in children under 2 years of age - bronchiolitis.

When colds become more serious

In infants and toddlers, infections with common cold viruses produce a lower respiratory tract infection called bronchiolitis, a leading cause for admission to most children’s hospitals in the U.S. (AP Photo/Zia Mazhar)
In infants and toddlers, infections with common cold viruses produce a lower respiratory tract infection called bronchiolitis, a leading cause for admission to most children’s hospitals in the U.S. (AP Photo/Zia Mazhar) (AP Photo/Zia Mazhar)

Did you know that the viruses that cause colds (acute upper respiratory tract infections) in children and adults cause a completely different disease in children under 2 years of age? In infants and toddlers, infections with common cold viruses produce a lower respiratory tract infection called bronchiolitis. In the wintertime, bronchiolitis is the leading cause for admission to most children’s hospitals in the U.S. 

One virus in particular, respiratory syncytial virus or RSV, is responsible for many cases of bronchiolitis. In addition to fever and runny nose, children with bronchiolitis have trouble breathing and develop wheezing. In some cases the symptoms are so severe that hospitalization is required. 

What are the signs and symptoms of bronchiolitis? Like older children with colds, infants with bronchiolitis often develop fever, cough and runny nose. Wheezing allows the healthcare provider to differentiate bronchiolitis from the common cold. 

When should you call the doctor? Fast rates of breathing accompanied by wheezing or decreased drinking occur in many infants. Infants who become lethargic, develop sucking in of the ribs or the abdomen, flaring of the nostrils or grunting with each breath should be evaluated immediately by a healthcare professional.  Infants who do not produce at least one wet diaper every 8 hours should also be evaluated. 

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Many otherwise healthy infants may develop bronchiolitis. But the groups at greatest risk for infection and hospitalization are premature infants under 2 years of age who are at least 2 months early (32 weeks of gestation or less); those children under 2 years of age with chronic lung, neurological or muscle disorders; those under 2 years of age with severe heart disease; and infants under 3 months of age at the start of bronchiolitis season who are between 32 and 35 weeks of gestational age. Infants in these groups who develop bronchiolitis should be evaluated by their healthcare provider. 

What is the treatment for bronchiolitis?  As with the common cold and other viral infections, there is no specific treatment for infants with bronchiolitis. Fever control with ibuprofen, clearing the nose with saline drops and a bulb aspirator and keeping your child hydrated with regular feedings and supplemental water are the most important things that parents and caregivers can do at home for these infants. 

Can bronchiolitis be prevented?  No vaccine is currently available for all children. Those children at greatest risk for infection and hospitalization may receive monthly injections of palivizumab (Synagis), an antibody that protects against RSV infection, throughout bronchiolitis season (October to April in the U.S.).  

About this blog
Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Mario Cruz, M.D. St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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