Touching Lives - December 2002
Bronchiolitis: Hunting for clues into a life-threatening baby infection
Her mother Sian, from Anglesey, North Wales, reflected: “I can think of no experience in life that compares to having a sick child, and being totally dependent on others to keep them alive. The feeling of inadequacy was terrible, it felt like being on the outside looking in on somebody else’s life.”
It was January 2001 and Erin was suffering from bronchiolitis. The condition is a severe lung disease that primarily affects babies and children, and is the most common single cause of infant hospital admissions in the UK.
Despite its prevalence, a MORI poll commissioned by Action Medical Research found that 54% of parents had never heard of the condition. Only 4% of people who were aware of it correctly defined it as a disease that affects babies and children, and one in ten confused it with the better-known lung infection, bronchitis.
Each year in the UK, bronchiolitis results in the hospitalisation of some 20,000 infants under one year old, and as a seasonal disease, most cases peak between November and March.
To coincide with this period Action Medical Research has launched an awareness campaign, and announced new project funding to help increase the clinical understanding of bronchiolitis.
What is bronchiolitis?
Bronchiolitis is a respiratory disease in which the lower airways in the lungs become inflamed and swollen. Most cases are caused by an infection with Respiratory Syncytial Virus (RSV), a highly contagious virus that causes cold-like symptoms and will have infected almost all children by the time they reach the age of two.
The majority of cases are harmless and cause only mild symptoms in affected youngsters. But it can to lead life-threatening chest complications in others, and the reasons for such diverse reactions to RSV are not understood.
About a third of infants infected with RSV go on to develop bronchiolitis, which infects the bronchioles (the tiny air passages deep in the lungs), giving rise to breathing difficulties. The influx of cases during the epidemic months causes a significant burden on hospital paediatric resources every year.
Professor Rosalind Smyth, Professor of Paediatric Medicine at Alder Hey Children’s Hospital in Liverpool, is leading a team to further improve our understanding of the illness. Last year the Charity agreed to extend this promising project by a further 12 months through an extra £50,000 funding. The three-year study has now received more than £140,000 from Action Medical Research.
Professor Smyth, who is internationally renowned in her field, told us: “Every winter, without fail, there is a huge number of babies with bronchiolitis being cared for in Intensive Care. But there is much that we don’t know about RSV infection, not least why it causes life-threatening chest infections in some infants but trivial symptoms in others.
“We know that some babies are susceptible to developing bronchiolitis, such as pre-term infants and those with underlying diseases such as congenital heart problems. But why should well-nourished, vigorous and healthy babies develop it?”
The team, which includes the paediatric research fellow Dr Paul McNamara, has been examining how the human body responds to RSV, by looking at fluid taken from the lungs of babies critically ill with bronchiolitis as part of their routine care in ICU.
Studies so far have discovered that babies born full-term display greater inflammation in the lungs than premature babies, in a way that suggests there are different disease processes. In particular, the team has found that the ^inflammation in full-term babies has striking similarities to that seen in older people with asthma^. This might help to explain the link between RSV bronchiolitis and wheezing in later childhood.
Professor Smyth adds: “These intriguing results have identified important patterns of inflammation which the team will further investigate, thanks to the additional funding from Action Medical Research. As our understanding of RSV bronchiolitis develops, so does the likelihood of new treatments and an all-important RSV vaccine.”
Read The Facts
Action Medical Research has produced a factsheet, which is designed to give parents and carers the facts and figures they need regarding the respiratory illness.
Endorsed by Liverpool-born television presenter Esther McVey, the fact sheet is available free of charge. For a copy please send a stamped, self-addressed envelope to:Bronchiolitis Factsheet,
Action Medical Research,
Alternatively, download a copy from the bronchiolitis campaign page