Bronchiolitis is swelling and mucus buildup in the smallest air passages in the lungs (bronchioles), usually due to a viral infection.
Bronchiolitis usually affects children under the age of 2, with a peak age of 3 - 6 months. It is a common, and sometimes severe illness. Respiratory syncytial virus (RSV) is the most common cause. Other viruses that can cause bronchiolitis include:
    * Adenovirus
    * Influenza
    * Parainfluenza

The virus is transmitted from person to person by direct contact with nasal fluids, or by airborne droplets. Although RSV generally causes only mild symptoms in an adult, it can cause severe illness in an infant.

Bronchiolitis is seasonal and appears more often in the fall and winter months. It is a very common reason for infants to be hospitalized during winter and early spring. It is estimated that by their first year, more than half of all infants have been exposed to RSV.

Risk factors include:

    * Exposure to cigarette smoke
    * Age younger than 6 months old
    * Living in crowded conditions
    * Lack of breast-feeding
    * Prematurity (being born before 37 weeks gestation)


Some children have infections with few or minor symptoms.

Bronchiolitis begins as a mild upper respiratory infection. Over a period of 2 - 3 days, it can develop into increasing respiratory distress with wheezing and a "tight" wheezy cough.

Symptoms include:

    * Bluish skin due to lack of oxygen (cyanosis)
    * Cough, wheezing, shortness of breath, or difficulty breathing
    * Fever
    * Intercostal retractions
    * Nasal flaring in infants
    * Rapid breathing (tachypnea)


Sometimes, no treatment is necessary.

Supportive therapy can include:

    * Chest clapping
    * Drinking enough fluids. Breast milk or formula are okay for children younger than 12 months. Offer warm lemonade or apple juice if your child is over 4 months.
    * Breathing moist (wet) air helps loosen the sticky mucus that may be choking your child. You can use a humidifier to moisten the air your child is breathing. Follow the directions that come with the humidifier.
    * Getting plenty of rest
    * Do not let anyone smoke in the house, car, or anywhere near your child.

Antibiotics are not effective against viral infections. Most medications have little effect on bronchiolitis. Children in the hospital may need oxygen therapy and fluids given through a vein (IV) to stay hydrated.

In extremely ill children, antiviral medications (such as ribavirin) are used in rare cases.

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