PEDs infectious diseases- Bronchiolitis Flashcards
Clinical presentation
Fever, rhinorrhea, cough, sneezing
increased work of breathing: nasal flaring, accessory muscle breathing, can progress to respiratory failure in some cases
may take up to 2 weeks to resolve and symptoms often peak around day 5
What causes bronchiolitis
RSV
RSV
90% of children infected before 24 months
season generally November to April
Risk factors
Age <6 M
Pre-term birth
Cyanotic or complicated CHD
Chronic lung disease
Weakened immune system
Treatment - EXAM Q
Mainstay of treatment is supportive therapy
oxygen, hydration, mechanical ventilation, ECMO
Prevention
Hand washing, isolation, sick pods
Influenza vaccine - everyone 6 months and older
children 6 months to 8 years who have not gotten 2 doses –> 2 doses seperated by 4 weeks then can go to 1 dose annually
RSV
Nirsevimab
RSV protection for infants - EXAM Q
two ways to protect babies from severe RSV disease
1. Vaccination of pregnant people (32-36 gestation)
2. Monoclonal antibody for infants
- Palivizumab
- Nirsevimab
Vaccination of pregnant people
Bivalent RSVpreF vaccine (must be Pfizer)
who qualifies
- women 32-36 weeks pregnant
administered before and during start of RSV season (Sept-jan)
Provides protection if given at least 14 days before delivery
Monoclonal antibodies for infants
used on babies born during RSV season and whos mum did not get RSV vaccine or gave birth before 14 day wait person of vaccine. Also for infants <8 months of age
Who qualifies for 2 doses of nirsevimab
infancts 8-19 months entering 2nd season with increased risk for severe disease may get second dose
- chronic lung disease
chronic corticosteroid therapy, diuretic therapy, supplemental oxygen withing 6 month period before the start of the second RSV season
immunocompromised
hemodynamically significant congenital heart disease
