Enterovirus: What does wheezing sound like? When should you seek help?
The enterovirus infections that have sprung up in the Midwest have brought the words “wheezing” and “respiratory distress” into the mainstream. But how, as a parent, do you know if your child is wheezing? And when is it bad enough to contact a doctor or seek care?
Parents of asthmatics become adept at recognizing breathing difficulties. But enterovirus D68 is also affecting children who have never before experienced respiratory distress. In serious cases, it’s landing them in intensive care.
Parents are finding themselves in a tough position, trying to evaluate their child’s symptoms in light of a serious health threat while wondering if they’re overreacting to a common cold. Doctors, too, are still finding their feet amid the recent influx of cases.
As time goes on and more cases are treated, “we probably will come to a better understanding of those children at greatest risk,” said Dr. Paul Krogstad, a professor of pediatrics in the infectious diseases division at Mattel Children’s Hospital UCLA . “We may find a way to distinguish D68 versus another trigger” for respiratory distress. “But presently, we’re not there.”
Lab testing alone to detect “a viral trigger” is rather slow, Krogstad told the L.A. Times. A throat or nose swab is used to detect the virus, and it takes “many hours or days” to get results.
So, as is frequently the case when your child is ill, you watch out in case things get worse and do your best to cope. While you’re busy with that, here are a few things to consider:
Here’s what wheezing sounds like
“A wheeze classically is a sort of continuous sound, with a buzzing quality to it,” Krogstad said. It can affect the entire chest or just part of it. But don’t be surprised or dismissive if you hear nothing. Wheezing may not be audible without a stethoscope. Doctors will use that instrument to listen for the characteristic continuous noise and delayed expiration.
Lack of wheezing doesn’t mean everything is OK
“Some children, of course, don’t have wheezing that you can hear with a stethoscope when in the midst of a very severe attack,” he added. “Air flow may be so low ... you don’t generate a noise.” So it’s not just the presence or absence of wheezing but the total degree of respiratory distress.
Rapid breathing, retractions are signs of distressLook for faster breathing. Are there visible retractions? That’s when the skin can be seen sucking in, between the ribs, for instance. When breathing difficulty is more severe, retractions may be visible just above the breastbone and collarbone.
Listen to what your child says
Take into account complaints about breathing or discomfort. And if your child is too young to talk, look for persistent coughing and fever. Babies in respiratory distress often appear uncomfortable and have trouble eating.
Are the usual things not working?
If your child has asthma and becomes ill, see if the usual treatments work, Krogstad said. If an inhaler that normally helps with intermittent asthma doesn’t seem to make a difference, seek a doctor’s advice. The same goes if signs of distress return very quickly after the inhaler is used.
When to seek care ...
When symptoms are mild, you can go with fluids, rest and medicines to reduce fever and discomfort. But if symptoms get worse or don’t improve within a week, or if there are signs of respiratory distress, get your child to the doctor. Severe breathing difficult or blue lips are reason to head for the closest emergency room, experts said.
