Asthma and Viral-induced Wheeze

Asthma is a condition which affects the airways – the small tubes that carry air in and out of the lungs. These airways are extra sensitive to substances (or triggers) which irritate them. Common triggers include colds, house-dust mite, pollen, smoke, furry animals etc.

When the airways come into contact with a trigger, the muscles around the walls of the airways contract and become tighter. The lining of the airways swells and produces a sticky mucus. When the airways narrow, it becomes difficult for air to move in and out.

Common symptoms are coughing, particularly at night and after exercise; wheezing or a whistling noise in the chest; or shortness of breath.

When your child’s asthma is treated and well controlled, he or she should be able to remain free from symptoms and lead a normal life.

Breathlessness and wheezing can occur with a respiratory viral illness, such as a cold, usually lasting 2-4 days, but sometimes longer. Between colds, children are usually free of wheeze, even when they are exercising.

Nearly one-third of all pre-school age children will wheeze on at least one occasion when they have a cold. Children with asthma may also wheeze. The difference between asthma and viral induced wheeze is that children with asthma will wheeze at times other than when they have a cold – often with exercise or when they are exposed to ‘triggers’, like house-dust mites or pets.

Most children with viral-induced wheeze will stop wheezing as they get older and will not develop asthma.

Make sure your child uses their medication as directed. There are two main types of asthma inhalers. They are called relievers and preventers and they work in different ways.

Reliever (blue inhaler):

• Salbutamol
  Relievers are taken immediately when asthma symptoms appear. They quickly relax the muscles surrounding the narrowed airways. This allows the airways to open wider, making it easier to breathe again. A reliever should provide relief of symptoms for four hours, if not, medical attention should be sought.

Preventer (brown, orange, purple inhalers) for example:

• Beclomethasone (Clenil Modulite®)
• Fluticasone (Flixotide®)
• Budesonide (Pulmicort®)

Preventers protect the linings of airways. They help to calm down the swelling in the airways and stop them being so sensitive.

Preventers reduce the risk of severe attacks. The effect builds up over a period of time. It can take up to 14 days to see an improvement when your child starts to use a preventer inhaler, so it needs to be taken every day, usually in the morning and evening, even when your child is feeling well.

Prednisolone (steroid tablets). A short course of steroid tablets (3-5 days) is sometimes needed to treat an asthma attack. The tablets bring severe asthma symptoms under control quickly. These are best taken after breakfast in the morning to reduce the risk of stomach irritation.

Montelukast blocks the effects of chemicals in the body that cause inflammation and narrowing of the airways. This may be given as a short course but some children may need to take Montelukast regularly.

There are many different types of inhaler devices. It is important that you and your child know how to use the device that he or she has been given. A spacer with an inhaler is the preferred device for most age groups. Your child’s inhaler technique should always be checked in the asthma clinic or before going home from hospital.

Encourage your child to do a full range of activities. There is no need to protect your child from activity or exercise, but they may sometimes need to use an inhaler beforehand.

Inform your child’s school about his or her asthma. Each school has an asthma policy.

If you smoke, try to stop, as smoking, even outside, can have an unwanted effect on your child, especially if he or she has any respiratory symptoms, such as asthma. If you must smoke, you should do it outdoors, as your child will be even more susceptible to the effects of tobacco smoke in a confined space such as indoors or in a car.

Be aware that even if you smoke outside, you will still be breathing out the chemicals from the tobacco and they will also be present on your clothes for 20-30 minutes after finishing your cigarette. Your child will be affected by these chemicals. You should avoid picking up your child or having close contact with him or her during this time period.

If you want to give up smoking, please contact your GP or practice nurse, or access services through Onelife Suffolk on 01473 718193 or online at www.onelifesuffolk.co.uk

If your child is over six years old and has been asked to use a peak flow meter, this should be done every morning and evening and the result recorded in their peak flow diary. You should record the highest number from three attempts.

Make sure your child receives their regular medication consistently, following the Asthma/Wheeze Management Plan provided by their GP, hospital consultant or nurse.

Follow your child’s Asthma/Wheeze Management Plan.

If you are concerned your child’s symptoms are getting worse, use the ‘traffic light’ to check their symptoms and treat accordingly.

Asthma UK Helpline
Telephone: 0300 222 5800, 9am-5pm, Monday to Friday
Web address: www.asthma.org.uk

Ipswich Hospital Switchboard: 01473 712233
Paediatric Assessment Unit: 01473 702198
Paediatric Respiratory nurses: 01473 702196
Bergholt Ward: 01473 702194
Children’s Emergency Department: 01473 702339