Signs and Symptoms of RSV and Bronchiolitis

What Parents Should Know About This Common Childhood Infection

Updated February 23, 2018
Mother examining baby boy (6-11 Months) with thermometer
Science Photo Library - RUTH JENKINSON./Brand X Pictures/Getty Images

Bronchiolitis is a lung infection usually caused by the respiratory syncytial virus (RSV), which produces swelling and mucus production in the small breathing tubes of your child's lungs. Infections are most common during the winter. Learn the signs, symptoms, and treatments for bronchiolitis.

Causes

Bronchiolitis is usually spread from the secretions from another person that has RSV, either another infant with bronchiolitis or an adult who may just have a cold.

Frequent hand washing and avoiding others who are sick can decrease your child's chances of getting this common infection.

Infants aged 2 to 12 months are the most likely to develop bronchiolitis. Although older children can also become infected, they often just develop symptoms of a common cold, such as a runny nose and mild cough.

There is a preventative medication (Synagis) that is taken monthly during the peak season of RSV (November to April) and if your baby was premature or if he already has difficulty with his lungs, then he may need to take this medicine.

Signs and Symptoms

For children with bronchiolitis, after developing a runny nose and cough, over the next few days, the cough will worsen and may become tight sounding and your child may develop other RSV symptoms, including fever, wheezing, and difficulty breathing.

Symptoms, especially the coughing and wheezing, may persist for three or four weeks, although they should gradually be improving during that time period.

You should see your doctor if your child is having difficulty breathing. You can tell if your child is having trouble breathing if he is breathing faster than usual, if you can see the muscles in between his ribs or at the base of his neck moving in and out (retractions), if he has nasal flaring, or if he is very irritable or lethargic.

Treatment

There is no cure for bronchiolitis, although some children do improve with breathing treatments with Albuterol nebulizer solution.

You will also want to do other things to make your child more comfortable, like giving a pain and fever reliever, plenty of fluids, using a cool mist humidifier, and saline nasal drops with frequent suctioning. You should likely think twice before trying an over-the-counter decongestant or cough suppressant, since they usually don't work in young children with RSV, and an FDA cold medicine health alert has advised against their use. Avoid putting your small child at risk by using these controversial products.

There is conflict about the use of steroids as a treatment for bronchiolitis, but they are often used if your child may also have asthma or reactive airway disease.

Antibiotics are not effective for bronchiolitis unless your child develops a secondary bacterial infection, such as an ear infection.

While most children do very well when they have bronchiolitis, some do need to be hospitalized. Treatments in the hospital will likely include oxygen if needed, IV fluids, chest physiotherapy (CPT), and frequent suctioning. Occasionally, a child with severe difficulty breathing may need to be intubated and placed on a ventilator.

Sources:

Brochiolitis. MedlinePlus. https://medlineplus.gov/ency/article/000975.htm.

Most Young Children With a Cough or Cold Don't Need Medicines. U.S. Food & Drug Administration. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm422465.htm.