What's the difference between bronchiolitis and a cold?

Parents should be able to differentiate between respiratory illnesses in various conditions to ensure timely and appropriate medical care for their children. Two commonly encountered respiratory conditions in young children are bronchiolitis and the common cold. While they may share similar symptoms, understanding the differences between these conditions is crucial in providing the best care for your child. This blog will explore the characteristics, causes, symptoms, and treatment options for bronchiolitis and the common cold, confidently helping parents navigate these respiratory illnesses.

What is Bronchiolitis?

Bronchiolitis is a viral infection that primarily affects infants and young children. It targets the smallest airways (bronchioles) in the lungs, causing inflammation and congestion. The most common viral culprit behind bronchiolitis is the respiratory syncytial virus (RSV), although other viruses can also be responsible.

Causes of Bronchiolitis

Bronchiolitis is primarily caused by the respiratory syncytial virus (RSV), which is highly contagious and quickly spreads from person to person through respiratory droplets. Other viruses, such as rhinovirus, adenovirus, influenza, human metapneumovirus and coronavirus, can also cause bronchiolitis in children.

What is Common Cold

The common cold, also known as an upper respiratory infection, is a viral infection that affects the nose and throat. It is caused by several different viruses, most commonly rhinoviruses.

Causes of the Common Cold

The common cold is predominantly caused by rhinoviruses, which are highly contagious and easily transmitted from person to person. Other viruses, such as coronaviruses, adenoviruses, and different strains of respiratory syncytial viruses (RSV), can also cause the common cold.

Symptoms of Bronchiolitis and the Common Cold

>Bronchiolitis: Most common in children up to the age of 2. Often begins with symptoms similar to a common cold, including a runny or stuffy nose, mild cough, and low-grade fever. However, within the next 48 to 71 hours, affected children may develop rapid breathing, wheezing, coughing, and difficulty feeding or sleeping as the illness progresses. Infants with bronchiolitis might exhibit lethargy, decreased activity, and increased irritability. Severe cases of bronchiolitis can lead to respiratory distress, characterized by rapid, shallow breathing, retractions (drawing in of the chest between the ribs), and bluish discoloration of the lips or face.

>Cold: Characterised by nasal congestion, causing a stuffy or runny nose. Children with a cold often experience frequent sneezing and a mild cough. A sore throat can accompany the common cold, leading to discomfort and difficulty swallowing. While some children with a cold may develop a low-grade fever, it is typically less common and milder than bronchiolitis.      

Treatment for Bronchiolitis

The treatment for bronchiolitis depends on the severity of symptoms and the affected individual's age. Usually, bronchiolitis is a self-limiting condition that improves with supportive care. Here are some common approaches to treatment:

>Home Care:

• Ensure sufficient rest and hydration: Encourage the affected person, especially infants, to rest and drink plenty of fluids to prevent dehydration.
• Use a humidifier: Adding moisture to the air with a cool-mist humidifier can help relieve congestion and ease breathing.
• Nasal saline drops: Administering nasal saline drops or using a saline nasal spray can help clear nasal congestion.
• Antipyretics: Such as paracetamol (acetaminophen) to relieve fever

>Monitoring:

• Observe the individual's breathing: Keep a close eye on their breathing pattern, looking for signs of increased respiratory distress or difficulty.
• Monitor temperature: Regularly check for fever, as it can indicate the presence of an additional infection.

>Medical Intervention:

• Hospitalisation: In severe cases, hospitalisation may be necessary, especially for infants younger than 3 months, those with underlying health conditions, or those experiencing significant respiratory distress.
• Oxygen therapy: If oxygen levels are low, supplemental oxygen may be provided through a nasal cannula or mask to ensure adequate oxygenation.
• Intravenous fluids: In cases of dehydration, fluids may be administered intravenously to maintain hydration.
• Medications: Bronchodilators, such as albuterol, may be prescribed in some cases, but they have limited effectiveness for bronchiolitis and are typically reserved for specific situations.

>Prevention:

• Good hygiene practices: Handwashing before handling infants or young children can help prevent the spread of respiratory viruses.
• Avoid exposure to cigarette smoke: Keep infants away from secondhand smoke as it can worsen respiratory symptoms.
• Home isolation: may be needed for the affected infant or child if there are other vulnerable young children within the household.

Treatment for the Common Cold

The common cold is a viral infection that resolves within a week or two. While there is no cure or vaccine for the common cold, treatment focuses on relieving symptoms and supporting the body's natural healing process. Here are some common approaches to treating the common cold:

>Rest and Hydration:

• Get plenty of rest: Take time and allow your body to recover.
• Stay hydrated: Drink fluids such as water, herbal tea, or clear broths to stay hydrated and help thin/liquify mucus secretions.

>Over-the-Counter Medications:

• Pain relievers and fever reducers: Non-prescription pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce fever, relieve headaches, and ease body aches.
• Cough suppressants: Over-the-counter cough syrups or lozenges can help alleviate coughing and soothe a sore throat. However, note that coughing is a natural reflex that clears mucus from the airways, so cough suppressants should only be used as directed and when necessary.
• Decongestants: Nasal decongestant sprays or oral decongestant medications can temporarily relieve nasal congestion. However, prolonged or excessive use of decongestant sprays can lead to rebound congestion, so they should be used sparingly and for short durations (typically not more than 3-4 continuous days).

>Symptom Relief:

• Saline nasal irrigation: Rinsing the nasal passages with saline solution using a neti pot or nasal spray can help relieve nasal congestion and promote easier breathing.
• Warm saltwater gargles: Gargling with warm salt water can soothe a sore throat and provide temporary relief.

>Home Remedies:

• Steam inhalation: Inhaling steam from a bowl of hot water or using a humidifier can help loosen mucus, ease congestion, and relieve nasal discomfort. Be careful not to use very hot steam so as to prevent burns.
• Honey: Consuming warm tea or water mixed with honey can soothe a sore throat and temporarily relieve coughing. Note that honey should not be given to children under 1 year of age due to risk of infant botulism (muscle paralysis caused by the toxin of Clostridium botulinum bacteria that may be present as a contaminant).

>Prevention:

• Practice good hygiene: Wash your hands frequently with soap and water, especially after coughing, sneezing, or being in public places.
• Cover your mouth and nose: When coughing or sneezing, use a tissue or cough/sneeze into your elbow to prevent the spread of germs.

When to Seek Medical Assistance

> Bronchiolitis: Seek medical care if your child is experiencing severe respiratory distress, significant difficulty breathing, or if symptoms do not improve after a few days. Other signs that prompt immediate medical attention include bluish lips or face, extreme lethargy, dehydration, or poor feeding.

> Common Cold: Most cases of the common cold can be managed at home. However, it is advisable to seek medical care if your child has persistent high fever, severe sore throat, earache, prolonged symptoms (more than ten days), or if there are underlying medical conditions that may increase the risk of complications.

Differentiating between bronchiolitis and the common cold is crucial for parents in providing appropriate care for their children. Bronchiolitis, primarily affecting infants and young children, can cause more severe respiratory distress and may require medical intervention. On the other hand, the common cold is generally milder and self-limiting.