The Recent Cold Front increases Visits to Paediatric A & E due to Bronchiolitis
The recent cold front has made bronchiolitis the most common motive for consultation in children under two and infants arriving at Accident and Emergency. "The symptoms of this infection may vary greatly," explains Doctor Adalgisa de Caro, Paediatrician at Hospital Quirónsalud Murcia, "and usually start with a cold, nasal mucus, coughing and, sometimes, fever. After one or two days, the couch worsens and the child’s breathing becomes more agitated. Some of them may also experience difficulty breathing and have sounds in their chest, such as whistling or wheezing." This type of virus has a seasonal pattern, presenting during the cold months of the year, in particular during cold fronts, such as the one we experienced last year.
Infants under six months, and those that were born prematurely, are at greater risk of coming down with severe bronchiolitis, or requiring hospital treatment, "as are babies with severe heart or lung conditions, such as cystic fibrosis or bronchio-pulmonary dysplasia, and those with immune system deficiencies," states Doctor De Caro.
Its transmission mechanism is from person to person, due to which the child should not be in contact with family members who have a respiratory infection or a cold. "If this is not possible, avoid coughing close to the child, and wash your hands with soap and water before picking him or her up. You should also avoid crowds, like those at shopping centres or day care centres," suggests Doctor Maria Ángeles Martín, Paediatrician at del Hospital Quirónsalud Valencia. Another factor that favours infection, and that can worsen its evolution, is tobacco smoke, due to which we advise not smoking close to minors.
The natural course of bronchiolitis can last between 7 and 10 days. "But it is between the second and third day when things can tale a turn for the worse," indicates Doctor Martín, "which is why it is very important for parents and caretakers to know how to recognize the signs and symptoms of breathing difficulties that should alert them to go to a healthcare centre."
As this pathology has a viral origin, there is no specific or curative treatment. "The objective of the treatment is to control the symptoms through measures such as nasal flushing with saline solution, sleeping in a semi-seated position, and avoiding contact with tobacco smoke," advises Doctor De Caro.
This infection usually includes a fever, due to which anti-febrile medications, such as paracetamol, can be given to alleviate it. "Sometimes bronchodilators are indicated, though their use for bronchiolitis is very controversial, since their efficacy has not been proven in most cases. Depending on the clinical characteristics and the age of the child, the paediatrician may try salbutamol and, in case of a positive response, prescribe it for treatment; otherwise, he or she will recommend all the aforementioned measures, and periodic follow-ups to monitor the child’s evolution," specifies the specialist from Hospital Quirónsalud Valencia, Maria Ángeles Martín.
This respiratory infection requires stricter monitoring in infants under six months and, in particular, in those under three months, since they are at greater risk of developing complications.