The peak season for wheezing is from November to April every year. Just at the end of last month, there were news reports that a 1-year-old child in Hong Kong was diagnosed with influenza A complicated by pneumonia and roaring syndrome. After being admitted to the hospital, he had to stay in the Children’s Intensive Care Unit. The official medical name of wheezing is laryngotracheobronchitis (LTB in English). When the disease occurs, the patient’s lower throat near the vocal cords where the trachea is connected will become inflamed and swollen. Children under 5 years old are particularly at risk because their tracheas are much thinner than adults. Once inflamed and swollen, it will affect ventilation and make breathing difficult, leading to symptoms such asSea lion’s hissing cough and rough breathingIf the condition is severe, it will increase the risk of tracheal obstruction and suffocation.
Hissing is actually a common respiratory emergency in children and is highly contagious. It is mostly caused by viral infections. Common pathogens include: new coronavirus, parainfluenza or influenza virus, and adenovirus. It is mainly spread through droplets in the air and contact with surfaces contaminated by droplets. andPeople who have suffered from wheezing will not produce immune antibodies. Therefore, during the peak period of the disease every year, children, especially those under 5 years old, are likely to suffer from it again.
When wheezing first occurs, most sick children only have mild fever or cold symptoms with a runny nose. However, by the next day, they start to make a hoarse wheezing sound every time they inhale, and their voices become hoarse, and they continue to have a short dry cough like a sea lion’s hiss. When the condition worsens, there will be a wheezing sound similar to snoring when breathing and breathing, and the lower edges of the ribs on both sides may be sunken due to shortness of breath. In a more serious case, due to the swelling of the hypopharynx, acute obstruction of the upper trachea leads to suffocation, so the respiratory murmur suddenly disappears when the sick child is asleep. Clinically, the condition of wheezing can worsen rapidly in as little as 1 to 2 days. In addition, rare cases of unusually severe wheezing or related secondary infections may be complicated by pneumonia, or even respiratory failure and complete cessation of breathing.
Many parents have asked: Howling syndrome and asthma both cause noisy breathing. How to tell the difference? When an asthma attack occurs, a high-pitched “he…he…” wheezing sound will be made when exhaling, but no sound will be made when inhaling. If you suffer from wheezing, you will usually make a rough, noisy stridor that is a bit like snoring when you inhale. However, when the condition is severe, you may also have stridor during both expiration and inhalation.
However, ordinary people may not be able to tell which type of respiratory disease they are suffering from just by coughing and breathing sounds. Therefore, parents and caregivers are urged to seek medical treatment immediately when they notice that their children are coughing and breathing strangely. They should not wait until symptoms of hypoxia and suffocation such as purple lips, fingers and toes occur before sending them to the hospital to avoid increasing the risk of severe sequelae caused by brain hypoxia.
Furthermore, wheezing and asthma are two different conditions. Hissing is an obstruction of the upper respiratory tract, while asthma is a contraction of the lower respiratory tract (trachea) caused by obstruction and inflammation. The symptoms and treatments of the two are different. Only by getting a diagnosis early can you prescribe the right medicine and avoid missing the opportunity for treatment.
The author is Yang Wanfeng, consultant pediatrician at Hong Kong Adventist Hospital-Tsuen Wan
