Viral Induced Wheeze

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What is viral induced wheeze?
A wheeze is a high-pitched whistling sound produced by a narrowing of the airways when breathing. Difficulty in breathing and wheeze can occur when your child has a respiratory infection (an infection of the breathing system causing symptoms such as cough and runny nose) such as a ‘cold’. These wheezy episodes usually last between 2 and 4 days but can be longer. They can occur as a ‘one off’ or can occur repeatedly when your child picks up a viral respiratory infection (Recurrent Viral Induced Wheeze). As there is no prevention available against viral infections, some children do have recurrent viral induced wheeze.

Nearly one third of all pre-school age children will wheeze on at least one occasion when they have a cold. Children with asthma also wheeze. The difference between asthma and viral induced wheeze is that children with asthma will have a wheeze not only when they have an infection, but also during exercise or after being in contact with triggers such as pollen, pet hair and dust mites. Also, most importantly, children with viral induced wheeze will grow out of the problem by around 4 – 5 years old whereas children with asthma may continue to have wheezy episodes even above this age. Therefore if your child only develops a wheeze with a cold and is under five years of age it is likely they have viral induced wheeze rather than asthma, but we cannot be absolutely certain until they are above five years of age.

Management of viral induced wheeze in hospital
The doctor will determine if your child has a viral induced wheeze by asking you questions and examining your child. Depending on the severity of your child’s condition the doctor may prescribe your child medications which can help open the airways and make it easier for your child to breath. The in-hospital treatment for viral induced wheeze is essentially the same as for asthma.
Sometimes children may require oxygen therapy to help them breath more easily and/ or if they have a co-existing chest infection. Children who are unable to maintain their fluid intake due to breathlessness or fatigue may require fluid therapy. A supported sitting position may help to expand the lungs and improve breathing in children who have difficulty in breathing.

Management of viral induced wheeze at home
Once your child is well enough, the Doctor will discharge you home. You may also be given medications to take home depending on the treatment your child has required whilst in hospital. If your child is discharged with a reliever inhaler such as salbutamol your nurse should show you how to correctly use the inhaler with a spacer before you are discharged home. They will also give you a
treatment plan to follow. Whilst you are at home it is important to monitor your child to make sure their symptoms do not start to worsen.

Red flag symptoms:
– Wheeze and breathlessness
– Breathing more quickly than normal
– Becoming tired or drowsy
– Unable to talk in full sentences or becoming quiet
– Increased work of breathing – using tummy muscles/ribs sicking in/nostrils flaring