Viral-induced wheeze

Introduction

A viral-induced wheeze commonly occurs in children under the age of three. It is caused by a viral infection which usually starts out as a cough or cold. The wheeze is a whistling sound heard which presents when the child breathes out. 

A viral-induced wheeze is caused by a viral infection and often starts out with a cough or cold. The infection may cause a child’s small airways to narrow or may increase mucus production in a child’s lungs. It is more common in children under age three as their airways are smaller. The wheeze may return each time your child has a cold and can occasionally last for weeks. As your child's airways develop, they are likely to grow out of viral-induced wheezing however some children go on to develop asthma.

A viral-induced wheeze is diagnosed from a physical examination of your child. A health professional will listen to the child’s breathing, noting the rattling/whistling sound when your child breathes. They will also look for signs the child is working harder to breathe, including fast heartbeat or the tummy and ribs sucking in when breathing. Additionally, the doctor will also examine if the child has cold and flu-like symptoms (fever, runny nose, cough etc).

A wheeze often improves with a bronchodilator, which is a medication which is inhaled. A doctor will prescribe this medication and monitor the effect. Bronchodilators or relievers (e.g., Ventolin® or Asmol ®) help open the airways, allowing air to move in and out of the lungs more easily.

Your child may also be given a short course of oral steroids (e.g., Redipred® prednisolone) to help reduce inflammation in the airway.

Sometimes, children with a viral-induced wheeze need a short hospital stay. Reasons for staying in hospital include:

• difficulty breathing
• needing Ventolin® more than every three hours
• needing additional oxygen
• support with feeding.

If hospitalisation is required, your child’s condition will be monitored closely. Children will remain in hospital until their oxygen levels improve. During their hospital stay, children should be encouraged to eat small, frequent meals.

As a viral-induced wheeze is caused by a virus, antibiotics are not helpful.

When the clinical team are happy with your child’s progress, you will be discharged from hospital. You will be given training and education from staff before discharge to help manage your child’s symptoms at home.

Your child may need to continue treatment with a reliever at home. You will be given a plan outlining how often and when to administer this.

It is important nobody smokes near your child. Cigarette smoke (even on clothing) can make children wheeze.

If your child is still wheezy between inhalers and looks unwell, you should seek urgent medical attention.

Signs to look out for:

• fast breathing
• fast heartbeat
• tummy sucking in when breathing
• sucking in at the ribs when breathing
• grunting noise when breathing out
• agitation
• breathlessness, preventing speaking in sentences
• a scared, quiet and tired child.

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