Bronchiolitis

The first signs of bronchiolitis often resemble those of a cold: runny nose, mild cough and sometimes a slight fever. However, after 3 to 5 days, symptoms can worsen with marked breathing difficulties, including rapid wheezing or crackling, persistent coughing and feeding difficulties.

Typical symptoms :

In cases of severe bronchiolitis, signs of cyanosis may appear, in particular a bluish tinge around the lips or fingernails indicating a lack of oxygen.

Bronchiolitis is mainly caused by respiratory viruses. The virus most frequently involved is the respiratory syncytial virus (RSV), which is responsible for the majority of cases. This virus is highly contagious and spreads easily through droplets of saliva or mucus when an infected person coughs or sneezes. It can also be transmitted by contact with contaminated surfaces, such as toys or door handles.

Other viruses that can cause bronchiolitis:

• Some factors increase the risk of developing severe bronchiolitis:
• Prematurity: infants born prematurely have less developed lungs and weaker immune systems.
• Age: babies under 6 months are more vulnerable.
• Underlying heart or lung conditions: children with heart defects or chronic lung disease are at increased risk.
• Exposure to cigarette smoke: smoke aggravates inflammation of the respiratory tract.

Bronchiolitis is often diagnosed after a thorough clinical examination by a doctor. A stethoscope is used to listen for crackling or wheezing sounds, which are characteristic of airway obstruction. Several tests can be carried out to confirm the diagnosis or assess the severity of the disease.

Common diagnostic tests:

Treatment for bronchiolitis is essentially symptomatic, as there is no specific treatment for the viruses responsible. Most mild cases can be managed at home with appropriate care. In severe cases, however, hospitalisation may be necessary.

Home care :

• Hydration: it is essential to maintain good hydration, especially if the child refuses to drink or eats little, by offering smaller quantities more frequently.
• Use of nasal saline solutions: to clear blocked nasal passages.
• Humidifiers: humid air can help relieve respiratory symptoms by making mucus more fluid.
• Rest: avoid any excitement or excessive physical activity that could make breathing worse.
• Ventolin: if the child also has bronchial tubes, Ventolin can be given.

Hospitalization

Children with severe symptoms, such as very low oxygen saturation or an inability to drink, may need to be admitted to hospital to receive oxygen, intravenous fluids and sometimes respiratory support.

Most children recover from bronchiolitis without serious complications. However, in some cases, complications can arise, including:

• Pneumonia: a secondary infection of the lungs.
• Atelectasis: part of the lungs collapses and can no longer be ventilated, leading to respiratory failure.
• Respiratory failure: in extreme cases, bronchiolitis can lead to respiratory failure requiring intensive care.
• Asthma: for severe forms requiring hospitalisation, the risk of developing obstructive bronchitis during childhood is slightly increased.

It is difficult to prevent bronchiolitis completely, because the viruses that cause it are so widespread. However, a number of measures can reduce the risk of transmission and limit the spread of the infection.

Preventive measures :

• Hand hygiene: regular hand washing, especially before touching a baby, is essential to prevent the transmission of viruses.
• Avoiding crowds and sick people: it is advisable to limit contact with people suffering from colds or flu, especially in winter.
• Sanitising the environment: regularly disinfect frequently touched objects and surfaces, such as toys and door handles.
• Limit exposure to smoke: avoid all exposure to cigarette smoke, which can aggravate symptoms and predispose you to infection.

There is no specific vaccine against RSV, but since 2024 in Switzerland, newborn babies have been able to receive injectable antibodies (Beyfortus) before or during their first winter, significantly reducing the risk of severe bronchiolitis. 

It is crucial to consult a doctor if the child shows signs of respiratory distress, such as :

• Very rapid or irregular breathing.
• Bluish lips or fingernails.
• Difficulty drinking or eating.

At Hôpital de La Tour, a multidisciplinary team is on hand to deal with cases of severe bronchiolitis. Thanks to state-of-the-art equipment and a paediatric emergency department capable of dealing with respiratory emergencies 24 hours a day, children receive attentive, personalised care.

1. What is bronchiolitis?
Bronchiolitis is a viral infection that affects the small airways in the lungs, causing inflammation and a build-up of mucus.

2. What are the main symptoms of bronchiolitis?
Symptoms include a persistent cough, rapid wheezing and feeding difficulties in infants.

3. What viruses cause bronchiolitis?
The respiratory syncytial virus (RSV) is the main cause, but other viruses such as rhinovirus, influenza or adenovirus can also be responsible.

4. How is bronchiolitis diagnosed?
The diagnosis is clinical, based on symptoms and respiratory examination. Additional tests may be carried out if symptoms are severe.

5. Can bronchiolitis be prevented?
Good hand hygiene and avoiding contact with people who are ill are important preventive measures, and injectable antibodies (Beyfortus) have been used since 2024.

6. What treatments are available for bronchiolitis?
There is no specific treatment. Treatment consists mainly of relieving symptoms, such as keeping well hydrated and using humidifiers.

7. Can bronchiolitis lead to complications?Yes, in some cases it can lead to complications such as pneumonia or respiratory failure.

8. When should I contact a doctor?
If your child has difficulty breathing, bluish skin or refuses to drink, it's important to see a doctor quickly.