Bronchiolitis - a surprisingly common disease
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 A Mother’s Story:
Little William Richards (Liverpool) was just one of the 20,000 babies a year in the United Kingdom who end up being admitted to hospital with the respiratory disease bronchiolitis. It’s a surprisingly common disease and yet few parents have even heard of it.

Six-week-old William became desperately ill with bronchiolitis within just a few hours. His mother Jayne, a consultant orthodontist at Liverpool University Dental Hospital commented: ‘William had a bit of a cough and a runny nose but it was nothing to be overly concerned about. However, later that day he refused his feed and became very lethargic. Then we became worried.’

Jayne’s husband David, a GP, consulted a colleague and the family took their son to the local Countess of Chester Hospital where an X-ray and nasal swab revealed William had an infection of the lungs caused by a respiratory syncytial virus (RSV).

Medics immediately prescribed antibiotics and inserted a breathing tube to help William. Later he was transferred to the regional leading children’s hospital Alder Hey in Liverpool, where he was ventilated and given specialist care.

William remained on a ventilator for six days and was eventually moved to a normal ward before being discharged days before Christmas.

Jayne says: ‘It was very frightening. It all happened so quickly – at 11am he was fine but by 11pm he needed a tube to help him breathe. The hospital staff were superb. The experience made me realise even more how much we love our little son. Having worked in the NHS for 15 years it was a very humbling experience to see the health service at its best." She continued: ‘It also brought home how important research in this area is, for future families like ourselves.’

Childalert provides up-to-the-minute information on illnesses, which affect children across the country. The website offers parents and child carers’ important pointers of what to look out for in case a child is suffering from what could potentially be a fatal illness.


BRONCHIOLITIS – THE FACTS

About 60 per cent of all babies will become infected with RSV before their first birthday. Up to a third of these children will go on to develop bronchiolitis, with the initial snuffles and coughs accompanied by a fever; breathing becoming faster and shallow, and feeding proving difficult.

Most babies recover quickly, but up to three per cent will develop severe bronchiolitis. In these cases a child may not be able to feed at all and will have a bluish tinge to the lips or complexion. This is caused by oxygen shortage and is a sign that urgent medical treatment is required.

Sometimes life-threatening chest complications can develop. A high proportion of these babies will need oxygen and/or tube feeding or intravenous fluids. A small percentage will need to be put on a ventilator to help them with their breathing.
Professor Rosalind Smyth and her team at the Institute of Child Health at Alder Hey Children’s Hospital, are working with the Department of Medical Microbiology at the Royal Liverpool University Hospital on a two year, £90,600 study of bronchiolitis in babies, funded by a grant from Action Research.

Professor Smyth comments: "This particular virus will have infected nearly all children by the time they reach the age of two, but it can cause life threatening complications in some infants and less severe symptoms in others. The reasons for this diversity are not well understood. We want to try to understand why some babies just get mild cold symptoms with this infection and others go onto develop serious illnesses like bronchiolitis."

The research team studies babies who are critically ill with RSV and bronchiolitis and compares them with babies who do not have this infection.

Professor Smyth says: "We know babies with underlying heart and lung disease are at a higher risk of developing RSV and bronchiolitis, but we also have healthy babies who are born at full-term who develop the disease. There is a huge range of cases and the precise reasons why some babies develop serious illness and some do not, are still not understood."

Professor Smyth admits parents often find the disease very frightening because of the speed at which their baby’s condition can deteriorate. "It can start off with the symptoms of a cold and within a day or two the baby’s breathing becomes very noisy and laboured and the baby can turn blue and have difficulties with feeding" says Professor Smyth. She continues: "The team will also be studying the possible long term effects of bronchiolitis, in particular whether these babies are at higher risk of developing asthma and wheeze later on in childhood."

Professor Smyth concludes: "The suspicion is that babies who suffer bronchiolitis are at higher risk of developing asthma and wheeze at a later stage. We will be following up a number of children who suffered bronchiolitis to see if that is the case."

Over the last three years Action Research has funded four projects specifically related to bronchiolitis, a total commitment of £326,192 has been raised to date.

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