Infectious diseases A-Z: What to know about bronchiolitis

Seasonal influenza isn’t the only viral illness to watch out for this winter, especially if you have young children and infants. Bronchiolitis is a viral infection that causes an inflammation of the small airways in the lungs. It can affect people of all ages, but the most severe symptoms usually occur in young children and infants.

“Bronchiolitis is one of the most common reasons that children come into the hospital and the emergency department in the wintertime. And RSV, or respiratory syncytial virus, is the most common cause of bronchiolitis,” says Dr. Nipunie Rajapakse, a pediatric infectious diseases specialist with the Mayo Clinic Children’s Center.

Rajapakse says a young child with bronchiolitis can present with a few different types of symptoms in addition to those usually seen with respiratory viruses, such as runny nose and cough.

“This includes looking like they’re using more effort to breathe. You might notice that their nostrils are flaring, that they’re kind of sucking in above their collarbone, or that they’re sucking in in between their ribs. They may look like they’re breathing faster than usual as well. Often in young kids, they won’t really want to feed, or their feeding will be not as good as usual. They may have fever.

“The most important thing is that they have their blood oxygen levels checked to determine whether they need extra oxygen and also to check their hydration status. One of the most common things we see in babies that are trying to fight this type of infection is that they can get dehydrated because they’re not feeding well,” says Rajapakse.

Bronchiolitis is caused by a virus, so antibiotics will not treat the infection. Bronchiolitis and bronchitis sound similar but are not the same illness.

“Bronchiolitis is inflammation of the smaller branches of the airways, which tends to affect younger children,” says Rajapakse. “Bronchitis refers to inflammation of the larger airways, and that tends to affect older children and adults.”

Prevention helps curb the spread of infection, and Rajapakse encourages good hand hygiene. “These infections are spread by respiratory secretions. If you have runny nose or cough, they are easily spread on your hands from person to person, and, so, washing your hands before handling your child, or if you’re handling any respiratory secretions, will help to decrease the risk of transmission.” Breast-feeding and avoidance of secondhand smoke also can provide some protection.

There are no vaccines for the most common causes of bronchiolitis including respiratory syncytial virus and rhinovirus, which is the common cold. However, an annual flu shot is recommended for everyone older than 6 months.