This lower respiratory disease is characterized by a deep, hacking (dry) cough that comes in sudden attacks. It results from inflammation of the bronchial tubes, the large airways that lead from the trachea (windpipe) to the lungs. The disease occurs in two forms: acute infectious bronchitis (usually viral) and allergic asthmatic bronchitis.
The disease is common in early childhood, particularly during the first four years of life; it afflicts boys more often than girls and occurs most frequently during the winter, the peak season for viral infections. In children, the trachea can be infected as well, a condition known as tracheobronchitis, if the larynx (voice box) also is inflamed, the disorder is called laryngotracheobronchitis.
The characteristic cough is the most troubling symptom of bronchitis. It worsens during sleep, waking the child frequently. In addition, the child may develop a wheeze (a whistling or sighing sound) with each breath as air passes through the narrowed bronchi over accumulated mucus.
WHAT CAUSES BRONCHITIS?
In the past, bronchitis was often associated with measles and whooping cough. Acute viral bronchitis develops when a virus causing an upper respiratory tract infection invades the bronchi, triggering inflammation and the secretion of excess mucus. Asthmatic bronchitis is triggered by exposure to a substance to which the child is allergic.
WHAT HAPPENS DURING BRONCHITIS?
A bout of bronchitis begins as an upper respiratory viral infection (a cold), with symptoms such as running, stuffy nose and low fever. After that, a persistent hacking cough develops lasting two to three days. The dry cough is succeeded by a loose cough that produces thick, yellow sputum.
Frequently, wheezing sounds develop when the child breathes, caused by the passage of air through mucus-clogged bronchi. Appetite loss and fatigue also are common, but they usually pass after two or three days. The cough itself should subside within seven to ten days.
IS MEDICAL ATTENTION NECESSARY?
Call your physician if the child develops sudden attacks of a persistent, hacking cough. Several different diseases (bronchiolitis, and pneumonia) can trigger such coughing spells. Bronchitis is the least severe of these disorders, and it usually has the mildest symptoms, but the doctor must rule out the others. By listening to the child's lungs with a stethoscope, the doctor will be able to detect the coarse wheezing sounds which are characteristic of bronchitis. A chest X-ray and sputum examination will facilitate the diagnosis.
After diagnosing bronchitis, the pediatrician will determine whether it is the viral or the allergic asthmatic form; they can have the same symptoms. The following characteristics suggest allergic bronchitis:
• The symptoms last longer than three or four weeks or recur frequently.
• There is a family history of allergic problems.
• The child has a history of wheezing, allergic rhinitis (inflammation of the mucus membrane of the nose) and allergic skin reactions.
WHAT TREATMENTS ARE AVAILABLE?
For the most part, treatment is supportive, consisting mainly of rest and fluids. A cough suppressant may be prescribed, although it is important for the child to do some coughing to clear the airways of mucus. The physician may prescribe antibiotics if he suspects a secondary bacterial infection. In the case of allergic bronchitis, the physician will treat the allergies directly.
CARING FOR A CHILD WITH BRONCHITIS
The following supportive measures will speed the child's recovery from both types of bronchitis:
• Adequate rest
• Adequate fluid intake to prevent thickened secretions from clogging the bronchi
• Humidified air to ease the child's productive cough, which clears the airways by making the child spit up loosened mucus
• Careful use of cough suppressants (so as not to completely suppress the necessary cough reflex) if unrelieved coughing prevents sleep and causes throat irritation
PREVENTING BRONCHITIS
If the child is prone to bronchitis, the following measures will reduce the chance of recurrences:
• Avoid smoking at home. Infants exposed to cigarrette smoke in the home are four times as likely to develop bronchitis as infants in a smoke-free environment.
• Wash your hands regularly and encourage frequent hand washing in the child to prevent the spread of viruses that cause bronchitis.
• Protect the child from exposure to conditions that trigger an allergic reaction.
• Protect the child from other environmental triggers, such as air pollution and cold climates.
GETTING HELP
Call your doctor if your child:
• Coughs persistently for longer than four or five days without showing any improvement
• Complains of pain during breathing, which is a symptom of pneumonia
