Viral Induced Wheeze

Often you may hear a whistling breathing noise (wheeze) that your child makes when he/she is unwell with a cold. This could possibly be a viral induced wheeze. In this article, we talk about why it’s important to be able to identify a wheeze and what can be done about it. We often find that some children are just more prone to getting a wheeze than others. Let’s find out some more…

What is viral induced wheeze (VIW)?

Viral induced wheeze is pretty much what the name says. It’s a wheeze that is caused by a virus which irritates the airways. This causes the airway tubes to swell and narrow making it a little more difficult to breathe and you may hear the whistling noise which we call a wheeze.

The timing of the wheeze usually occurs in and around a respiratory tract infection. You might notice that your child has a wheeze when they have a cough or a cold but in between when they are well the wheeze disappears.

At what age would I expect my child to have VIW?

Viral induced wheeze generally affects children between the ages of 6 months and 5 years of age. Children under the age of 3 years are a lot more prone to wheezing because their airways are a lot smaller.

What could cause my child to have viral induced wheeze compared to other children?

Children that may have had bronchiolitis when they were under the age of 1 or those who are exposed to cigarette smoke may develop viral induced wheeze more commonly.

Does the wheeze go away?

In most children, the wheeze will settle by the age of 6. That means, after the age of 6, they should not get an associated wheeze with their viral illnesses. Each year you may notice that with each cough and a cold, that the wheeze becomes less and less until eventually the child will grow out of the condition.

How many children are impacted by viral induced wheeze?

A study conducted in 1995 found that 50% of children younger than 6 years of age had at least one respiratory tract infection with an associated wheeze.

How long will the wheeze last?

The wheeze is caused by the respiratory tract infection which usually resolves on its own when it is viral. On average, a fever with a viral respiratory tract infection will settle after 3-7 days and the associated cough and wheeze should settle within around 3 weeks in most children.

Will my child go on to develop asthma if they have viral induced wheeze (VIW)?

Around 15% of children who develop a wheeze under the age of 5 year will continue to wheeze and have asthma.

So, is viral induced wheeze the same as asthma?

No. Viral induced wheeze and asthma are both different diagnoses as they have a very different underlying mechanism. The main difference is that viral induced wheeze is always associated with a respiratory tract infection and is found in under 5’s where as asthma can be triggered by multiple things.

What sort of symptoms should I look out for that may indicate asthma?

Night time cough that is regular
Family history of asthma or allergy
Child has hayfever, eczema or other allergies
Wheezing is heard when exercising and not just when they have a cough/cold

If I take my child to the GP what will they do?

Your healthcare provider in the community (GP) will examine the child, measure their heart rate (HR), breathing rate (RR) and oxygen saturations (O2 sats). Based on the history (the story behind what’s happened), the examination and the bedside investigations, (HR, RR, O2 sats) they will determine if the best course of action is to take your child to hospital for observation and management or to continue to monitor in the community.

Will my GP prescribe an inhaler?

Sometimes a GP will suggest a trial of a blue inhaler called salbutamol to help open up the airways. They will most likely book a review appointment to see whether the inhaler has helped or that the wheeze has settled.

Child using a salbutamol inhaler with a spacer device

As a parent when do I know to take my child to hospital?

Look out for severe symptoms including:

Agitation
Reduced consciousness
Signs of exhaustion (not able to complete sentences/ not responding properly)
Blue lips or hands/feet
Increased work of breathing (breathing a lot faster and using a lot of energy to breathe compared to their baseline)

The signs above could indicate that not enough oxygen is going around your child’s body. Ring 999 for immediate help.

Please note: If your child has been born prematurely, has an underlying lung or heart condition, immune deficiency or you as a carer are unable to cope with the level of illness please seek help early on.

Disclaimer: Please note this article is made available for educational purposes only and is not a substitute for competent medical advice. If your child is unwell, you must consult a medical professional in person.

References:

For more information and answers to the questions below please book a place on the Webinar which will also include a 15 minute Q+A:

Thursday 14th October 2021 – 8pm

What does a wheeze sound like?
What’s a ‘happy wheezer’?
I struggle to decide whether it is a wheeze or upper airway noise. Any advice?
Will it permanently damage their lungs?
Any tips on how to deal with a wheezy child, especially at night?
Do steroid inhalers work?
My 3 year old won’t take an inhaler. What can I do to help?
My eldest has it with every cough, is my youngest going to develop it?
At what point do you say a salbutamol inhaler is not helping?