Respiratory Syncytial virus (RSV) and some other viruses may cause many types of upper respiratory illnesses in the winter months, especially bronchiolitis. RSV is notorious for causing remarkable coughing that can last for weeks. Many children with bronchiolitis are diagnosed as having pneumonia. Children, particularly infants, may wheeze like an asthmatic and those under 6 months of age may have  distress from the wheezing and labored breathing.  The breathing difficulty may interfere with normal drinking or eating.

Children with bronchiolitis may need to be admitted to the hospital so oxygen and intravenous fluids can be given. This is uncommon. Poor oxygen level or dehydration can be determined in the office unless you feel that your child can't breath. I advise that you take your child to Children's Emergency Room in Madera in that situation. Since this infection is caused by a virus, antibiotics don’t have a benefit. Secondary ear infections or pneumonia can develop, in which case, antibiotics will be considered.

In limited situations, an antiviral drug called Ribaviran™ may be used just for RSV life-threatening infections and very premature infants. It is not recommended for most cases of bronchiolitis, since most children do well and are not bothered by the severe cough or it’s complications.

It may be difficult to differentiate RSV from asthma-like illnesses and in some cases asthma medications like albuterol are tried. I restrict the use of these medicines to families with a strong history of asthma in the immediate family.