Bronchiolitis
Where are we now?
Members of bronchiolitis project team with baby on ward
Every year in the UK, some 20,000 babies under one year old will be hospitalised by a severe lung disease called bronchiolitis. [1]
Some will die.
Wards swamped every winter
Hospital wards are swamped every winter (October to March) by babies and children struggling to fight off this highly contagious disease for which there is no vaccine and no cure.
Yet most parents do not even know that bronchiolitis exists and have no idea what to look for when their babies fall ill.
Funding research, raising awareness
Action Medical Research has dedicated almost half a million pounds since 1998 to fund studies into bronchiolitis and the charity is committed to raising awareness of this disease - one of the most common cause of infantile hospital admissions in the UK.
Bronchiolitis: what is it?
Bronchiolitis is a respiratory disease in which the lower airways in the lungs become inflamed and swollen. The majority of cases are harmless and cause only mild symptoms in affected youngsters. But it can lead to life-threatening chest complications in others.
Most cases caused by virus
Doctor's checkup of a baby using a stethoscope
Most cases of bronchiolitis are caused by infection with a highly contagious virus called respiratory syncytial virus or RSV. All children are likely to become infected with RSV before they reach two years old and for most of them, their only symptoms will be similar to having a mild cough or cold. Doctors do not know why some children are not so lucky and develop such extreme reactions to RSV infections that they go on to develop bronchiolitis.
Erin's story
Erin Prytherch in intensive care
This was the case for little Erin Prytherch who spent five days critically ill in an Intensive Care Unit, during which time she was isolated to contain the infection. Erin's family endured great anguish during her time in hospital and while Erin's story had a happy ending, her family knows how lucky they were and that other babies do not always fare as well. Even those who beat off bronchiolitis can continue with a cough for many weeks afterwards while there is also an increased risk of developing asthma is later life.
Diverse reactions
We know that some factors, such as being born prematurely or having a heart problem, appear to make some babies more susceptible to developing severe bronchiolitis than others.
However healthy babies can also develop the condition and the reasons for the diverse reactions to the virus are not fully understood.
Action Medical Research probably invests more time, thought and funding into investigating this disease than any other charity. Our aims are to ensure that all parents know about bronchiolitis so they can be on their guard, and to raise money for research that might lead to treatments and a cure.
What are we doing?
In 2001, a MORI poll commissioned by Action Medical Research showed that most people (62 per cent) have never even heard of bronchiolitis.
Raising awareness
*MORI Social Research Institute interviewed a representative quota sample of 2,065 adults aged 15 and over. Interviews were conducted face-to-face in homes across Great Britain in 191 constituency-based sampling points. Interviews were carried out between July 25-30 2002.
Only four per cent of people who were aware of it correctly identified it as a disease that affects babies and children. And one in 10 confused it with the better-known lung infection, bronchitis.
The findings shocked us and we realised that a campaign was needed to tell parents about the disease and encourage more fund-raising to seek answers to this potentially life-threatening condition which drains hospital resources each winter.
The charity hosted a special press call at Alder Hey Children's Hospital in Merseyside. Liverpool-born television presenter Esther McVey helped launch a free factsheet, and met a team of researchers who were leading a pioneering project funded by Action Medical Research.
Liverpool based research team
Thanks to grants of more than £140,000 from Action Medical Research, our Liverpool-based research team carried out vital work which gives a valuable insight into how the body's immune system responds to RSV infection, taking us a step closer to developing new treatments and an RSV vaccine.
During the 3-year study, the team discovered that babies born full-term display greater inflammation in the lungs than premature babies, suggesting that different disease processes are involved.
In addition, the team found that a protein known as interleukin-9 (IL-9) is produced in very large amounts by immune cells in these infants' airways. This protein is more commonly seen in the lungs of asthmatics and causes mucus overproduction. In fact, many of the respiratory symptoms seen in children with bronchiolitis are caused by mucus overproduction.
The team also found that most infants with severe RSV bronchiolitis are also infected with another virus which may help to explain why some infants develop severe bronchiolitis while others have only trivial symptoms.
Professor Rosalind Smyth
Rosalind Smyth, internationally renowned Professor of Paediatric Medicine at the University of Liverpool and based at Alder Hey Children's Hospital, has been at the forefront of Action Medical Research's attack on bronchiolitis. She said: "Bronchiolitis is the most common cause of respiratory tract illness in children under one year old.
"At the moment there is no specific treatment for this condition. All we can do to help babies with bronchiolitis is to support them as best we can - for example with fluids if they can't feed and with oxygen and possibly a ventilator if they are having difficulty breathing. We just have to wait for the disease to take its course".
With funds raised through our Touching Tiny Lives Campaign, the Liverpool team has recently been awarded a further grant of more than £120,000 to continue their vital work and further our undertstanding of the processes that contribute to the severity of bronchiolitis.
Professor Smyth said: "As our understanding of RSV bronchiolitis develops so does the likelihood of new treatments and an-all important RSV vaccine".
Other studies funded by the charity since 1998 include:
£80,308 for Imperial College School of Medicine at Hammersmith Hospital, London, to investigate how an affected baby tries to fight off an RSV infection, in some cases causing its under-developed immune system to over-react leading to inflammation to the lungs. The team has discovered important mechanisms underlying this inflammatory process, which has set the scene for further studies and better targeted research towards anti-inflammatory treatments
£34,965 for scientists at Oxford University's Department of Paediatrics who discovered that babies have a genetic predisposition to developing bronchiolitis. A particular gene was identified as being important in determining disease severity.
£120,319 for researchers at the London School of Hygiene and Tropical Medicine who made important strides forward in the path towards the development of a vaccine against RSV.
by producing small parts of the virus and using them as a vaccine.
Action Medical Research is working hard to help improve our understanding of bronchiolitis, but we are dependent on donations from the general public to make these key breakthroughs.
The Action Medical Research campaign
- To raise awareness of bronchiolitis, particularly among parents and carers.
- To encourage more donations to help us fund continued research into treatments and cures.
What you can do?
Help us fund more research into the disease.
Footnotes
1. Allport TD, Davies EG, Wells C, Sharland M. Archives of Disease in Childhood 1997; 76:385 [back to main article]
