Wheezing And Asthma In Infants
Millions of kids under the age of 18 have asthma. Most develop symptoms by age 6 some do as young as by age 3.
Asthma is becoming more common in developed countries, though no one knows exactly why. But researchers are sure of one thing: Kids are more likely to develop asthma if theres a family history of allergies and asthma. This is especially true if a childs parents have asthma and certain allergies.
What Symptoms Should You Watch For In Your Child
Contact your childs doctor if common cold symptoms are complicated by any of the following:
- The child is younger than three months
- The child has ever been diagnosed with asthma or reactive airways disease
- The child has a fever
- above 100.4° in babies under 3 months old
- above 101° in babies 3-6 months
- above 102° in babies older than 6 months
or take your child to the emergency room for any of these symptoms:
- Signs of trouble breathing: nostrils widening with each breath rapid breathing skin above or below the ribs sucking in with each breath skin, lips or nails turning blue
- A severe headache behind or around the eyes or the back of the neck swelling or redness around the eyes
- Persistent vomiting or signs of dehydration: dry or sticky mouth few or no tears thirst discolored or less urine than usual
Viral Etiology Of Bronchiolitis And Asthma
Many respiratory viruses can cause bronchiolitis . Many studies from the 1970s and 1980s have shown that RSV is the dominant causative agent, and it is virtually the only agent inducing epidemics. RSV infection has been detected in 50% to 70% of patients with bronchiolitis , , . RSV is a rare pathogen in older hospitalized children , because nearly all children have been infected with RSV within the first 2 years of life, and a child’s initial RSV infection is typically the most severe. RSV epidemics usually begin yearly in the late fall and peak in November to March. In some countries, such as Finland, RSV infections occur in double-humped outbreaks in 2-year cycles , .
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How Can Adult Onset Asthma Be Managed
If you manage your asthma, you can expect to lead a normal lifestyle. Basically, there are four key steps to managing asthma successfully:
1. Learn about asthma and stay up-to-date on new developments.
2. Take prescribed medications. Dont make any changes until you check with your physician. Dont use over- the-counter medications unless prescribed by your physician!
3. Check your lungs daily at home by using a peak flow meter. Asthma patients often can detect lung changes with a peak flow meter before they actually experience any changes. Visit your physician regularly for further in-office tests. Lung testing is painless and provides valuable data that helps your physician make adjustments in your medication.
4. Make an asthma management plan with your physician. A plan establishes guidelines that tell you what to do if your asthma symptoms get worse.
When Should I Call My Healthcare Provider
- Fever .
- Fever lasting more than two days.
- Grey or blue tint to tongue, lips or skin.
- Difficulty breathing.
- Cold symptoms that have become severe.
Additional symptoms to watch for in young children include:
- Extreme fussiness, decreased alertness.
- Dehydration .
- Coughing continues day and night.
- Poor appetite.
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What Are Respiratory Viruses
They include rhinovirus , respiratory syncytial virus , parainfluenza, influenza, coronavirus, and metapneumovirus1. They most likely infect the upper airway causing common colds. Sometimes these colds become severe, in which case the viruses may infect the lower airways causing bronchitis, bronchiolitis, pneumonia and asthma2.
Environmental Influences On The Immunopathogenesis Of Atopic Asthma
Atopy and asthma may not be explained simply by the Th1/Th2 paradigm or abnormal proinflammatory or anti-inflammatory capacity, as suggested in a report by Heaton et al . These investigators showed mixed Th1/Th2 immune responses in wheezing children. Although they confirmed that allergic diseases and asthma are associated with Th2 production , they also showed that IFN- was associated with increased immediate skin test reactivity and with airway hyperreactivity . These findings are in agreement with findings from a mouse model, suggesting that Th1 responses could increase the severity of allergic diseases and asthma . IL-10 has been found to have a protective effect inhibiting immediate skin test reactions, as also stated earlier, but it also is associated with airway hyperreactivity in children without allergies and may increase the severity of airway disease in these subjects. The diversity of these responses may indicate that atopy is influenced not only by genetic heterogeneity, but also environmental effects, such as infections or exposure to allergens, which occur with varying intensities in different individuals .
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How Is The Condition Diagnosed
To diagnose asthma, your physician will question you about your symptoms, perform a physical exam, and conduct lung function tests. You also may be tested for allergies.
Your internist or family physician may refer you to an allergist or pulmonologist for specialized testing or treatment.
After middle age, most adults experience a decrease in their lung capacity. These changes in lung function may lead some physicians to overlook asthma as a possible diagnosis.
Untreated asthma can contribute to even greater permanent loss of lung function. If you have any asthma symptoms, dont ignore them, and dont try to treat them yourself. Get a definitive diagnosis from your health care provider.
My Baby Is Wheezing Is It Asthma
If your baby has a cold and is wheezing, you might wonder if the problem is asthma. But its not always clear if an infant has asthma. More important than getting a firm diagnosis is making sure your child gets treated for any breathing problems.
Asthma is a chronic disease of the lungs that causes the airways to swell, tighten, and produce excess mucus. It can be difficult to diagnose in children under the age of 5, especially in infants, because other conditions have similar symptoms.
Its also difficult to accurately measure babies lung function . Older kids and adults are better able to cooperate with lung function tests, which often involve taking a deep breath and blowing out as fast as the person can. This type of testing may show asthmatic changes in the lungs.
The mechanics of a babys lungs also complicate the diagnosis of asthma. Infants airways are small. When a baby gets a respiratory tract infection, these already small passages get swollen and filled with mucus much more easily than an older childs or an adults. This can lead to coughing, wheezing, and other symptoms of asthma .
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Can Respiratory Viruses Cause/trigger Asthma In Anyone
Although it has not been thoroughly disproved, chances are pretty good that respiratory viruses will probably not induce asthma in those who do not have asthma genes. This means that about 90% of the human population has no chance of developing virus induced asthma. So, only about 10 of individuals will have a predisposition to developing asthma.
Recurrent Wheezing And Asthma After Respiratory Syncytial Virus Bronchiolitis
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
Background: Respiratory syncytial virus is the most common pathogen of acute bronchiolitis in children, which sometimes triggers the development of recurrent wheezing and increases the risk of childhood asthma.
Methods: We enrolled 425 children who were diagnosed with RSV-infected bronchiolitis at the department of pulmonology, Children’s Hospital Zhejiang University School of Medicine in 2011. Long-term follow-up was performed to explore the consequence of bronchiolitis on subsequent recurrent wheezing and asthma.
RSV bronchiolitis might increase the incidence of recurrent wheezing and asthma. Allergic constitution was an important prerequisite for the occurrence of asthma, and related risk factor such as cesarean section can only increase recurrent wheezing to a certain extent within a certain period of time. And we also find higher birth weight and older onset age for those who develop asthma, which should be verified in the future.
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Expert Commentary & Five
To evaluate whether modification of infant RSV infection risk or severity can prevent asthma using strategies such as RSV immunoprophylaxis and birth timing
To understand the mechanisms through which infant RSV infection impacts the development of asthma, and to understand and identify the critical time periods during which RSV infection confers the greatest impact on asthma risk
While RSV infection is ubiquitous in young children, not all infants who develop bronchiolitis later develop asthma, thus, understanding how RSV infection interacts with genetic and other environmental risk factors will be important in asthma prevention, as well as selecting high-risk populations for primary prevention interventions.
Respiratory Conditions In Later Life
There may be a link between bronchiolitis and developing respiratory conditions such as asthma in later life. But the link is not fully understood.
It’s not clear whether having bronchiolitis as an infant increases your risk of developing asthma later in life, or whether there are environmental or genetic factors that cause both bronchiolitis and asthma.
If your child has repeated bouts of bronchiolitis, their risk of developing asthma later in life may be increased.
Page last reviewed: 06 August 2018 Next review due: 06 August 2021
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How Can I Tell If Its Rsv Or Covid
The symptoms of RSV and COVID-19 can be similar, but there are some differences.
- RSV is more likely to start with a very stuffy or runny nose.
- COVID-19 is more likely to start with muscle or body aches.
- COVID-19 is more likely to cause a loss of smell or taste.
- The symptoms of COVID-19 tend to be more severe in older people.
- The symptoms of RSV tend to be most severe in the youngest babies.
That said, both viruses can lead to lung problems, like pneumonia. And other viruses, like influenza, can cause respiratory symptoms, too. Its possible to have more than one virus at a time. Getting tested is the only way to know for sure which respiratory virus you have.
What Are The Symptoms And Long Term Effects Of Rsv In Infants
RSV in infants is a virus that is the root cause of most respiratory infections. While it is a common pediatric infection, there are cases in which babies need to be hospitalized because of serious complications due to lack of medical attention.
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What Causes Respiratory Syncytial Virus
RSV is spread from respiratory secretions through close contact with infected people or contact with contaminated surfaces or objects. Infection can occur when infectious material contacts mucous membranes of the eyes, mouth, or nose, and possibly through the inhalation of droplets generated by a sneeze or cough. The incubation period is about four to six days.
Can Bronchiolitis Lead To Asthma
It is easy for parents, and even medical providers, to confuse bronchiolitis and asthma. Both of these illnesses have several things in common, such as noisy or rapid breathing, fatigue, wheezing and coughing. Lastly, the viruses that cause bronchiolitis are the same viruses that can cause asthma flare ups.
One may also ask, what is the underlying cause of respiratory failure in a child with bronchiolitis? Mucus collects in these airways, which makes it difficult for air to flow freely in and out of the lungs. Most cases of bronchiolitis are caused by the respiratory syncytial virus . RSV is a common virus that infects just about every child by 2 years of age.
Moreover, can bronchiolitis damage lungs?
Bronchiolitis does not usually cause long-term breathing problems, but it can damage the cells in your child’s airways. This damage can last for 3 to 4 months in some children, causing persistent wheezing and coughing.
Can RSV cause asthma later in life?
RSV LRTIs are strongly associated and likely causal in the development of asthma, the most common chronic disease in childhood, causing significant morbidity and mortality throughout life. The more severe the bronchiolitis healthcare encounter is during infancy, the higher the risk of developing asthma later.
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What Is Respiratory Syncytial Virus
RSV is a common respiratory virus. By the time children are 2 or 3 years old, most have been infected by RSV at least once, with few problems. However, for some, the virus can be life-threatening and the infection sends more babies to the hospital than any other condition.
High-risk groups include:
- Babies less than one year who were born prematurely
- Infants under 6 months
- Children with asthma or reactive airways disease
- Patients of any age with underlying lung, heart or immune system problems, including cancer and transplant patients
RSV tends to occur and spread in the winter and early spring. It starts as an upper respiratory infection, with familiar cold symptoms. What makes it so dangerous is its ability to quickly spread down from the nose and throat into the lower respiratory tract, where it infects and causes inflammation in the tissues of the lungs and the tiny bronchial air tubes .
Inflammation is the bodys natural process for fighting infection, but in tiny infant airways or those already inflamed by asthma, it can cause increased airway obstruction and difficulty breathing.
RSV is also common among adults, particularly those with weakened immune systems such as people with asthma, COPD, cancer patients, those with either immunodeficiency or autoimmune disease, and those in close contact with large numbers of people, such as senior citizens living within group settings.
Rsv In Infants Symptoms
- The most common sign of onset of RSV is difficulty in breathing.
- The baby shows symptoms like runny nose, wheezing or coughing.
- Depressed area under the breastbone may occur.
- A sure sign of labored breathing is the constant rise and fall of the infants abdomen while inhaling and exhaling.
- When a baby has RSV, it will cause discomfort leading to a grumpy behavior.
- Irritability can be mistaken as colic, but observe the baby if he or she becomes more irritable than usual.
- Fever is another symptom of RSV. Contact the pediatrician if the breathing difficulty is accompanied by fever.
Children at Risk
Symptoms of RSV infection may be more pronounced in some children who have a higher risk.
- Infants born prematurely
- Children with serious heart ailments
- Children with lung problems
- Children with immunodeficiency disorder
Furthermore, RSV infections tend to affect babies in seasonal outbreaks.
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What Are The Mediators Of Inflammation
These are chemicals, or proteins, called cytokines, chemokines, leukotrienes, and histamine. They warn other airway cells of the invasion and tell them to prepare for battle. They also “mediate” inflammation. Some directly cause airway inflammation by causing airway epithelial cells to release some of their fluid into intracellular spaces. This inflammation is needed to trap viruses, although its also responsible for cold, allergy, and asthma symptoms. Some indirectly cause inflammation by recruiting granulocytes to airways. Granulocytes secrete more mediators to enhance the inflammatory response to cause worsening cold symptoms and persistent asthma symptoms.
Does Rsv Virus Lead To Asthma
Following RSV infection, a number of infants are known to develop recurrent wheezing and asthma symptoms. In fact, some epidemiological studies have shown that as many as 40% of infants who require hospitalization from RSV will develop these concerns.
Still, while infants who are hospitalized with RSV bronchiolitis are more likely to have asthma later on, most of us have had RSV infection at some time and do not have asthma. It remains unclear if RSV infection early on in life causes asthma or if infants who are genetically destined to have asthma are simply the ones to wheeze and get ill enough to be hospitalized if infected.
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How Do Viruses Cause Cold Symptoms
Respiratory viruses typically cause upper airway inflammation, resulting in your typical cold symptoms. This inflammation irritates nerve endings to cause a scratchy throat and irritating feeling in your nose and sinuses. They irritate goblet cells to cause increased mucus production to cause a stuffy and runny nose. This also results in nasal drainage. This mucus, while uncomfortable, is needed to move trapped viruses to the back of your throat.
Rsv In Infants Long Term Effects
RSV has been reported to have long term effects on children. They may develop asthma and other respiratory illnesses later in life due to this infection. For adults, they may face permanent damage to the lungs from prolonged use ventilator to alleviate difficulty in breathing.
Treating RSV in Infants
- Mild cases of RSV infection do not require hospital stay for treatment.
- Home care with medications to control fever and relieve the breathing problems is the common course of treatment.
- Babies with weakened immune systems may be admitted to the hospital for monitoring.
- Humidified or moistened oxygen, oftentimes mixed with special medications, is used in the treatment.
- Anti-viral medications may also be given, depending on how the doctors deem it fit.
- Most children will recover within a span of 8 to 15 days.
- Recurrence of RSV infection is common. When another bout with the virus occurs, the symptoms tend to be less pronounced.
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