Duration of illness in infants with bronchiolitis evaluated in the emergency department.
OBJECTIVE
To describe the duration of illness in infants with first-time bronchiolitis who present to an emergency department (ED) and assess the burden of the illness on caregivers and families.


METHODS
This was a prospective cohort study of infants younger than 12 months who presented to a tertiary care children's hospital ED with a first episode of bronchiolitis. Subjects were excluded if they had a history of bronchodilator use or immunocompromise. Demographic and clinical data were collected in the ED. Outcomes data were collected by weekly telephone interviews for 4 weeks or until the subject was free of cough for 24 hours.


RESULTS
Ninety-five infants were enrolled from November 2007 to March 2008. Median duration of symptoms was 15 days; 25% of the infants remained symptomatic after 21 days. Subjects with a history of eczema trended toward a longer median duration of symptoms when compared with those who did not (18 days [interquartile range (IQR): 15.5-24] and 15 days [IQR: 11-19], respectively; P = .055). Duration of symptoms did not significantly vary with regards to respiratory syncytial virus status or secondhand smoke exposure. Subjects missed a median of 2.5 days (IQR: 0.5-5.5) of day care, and caregivers missed a median of 2 days (IQR: 1-4) of work. Of these infants, 37.1% (95% confidence interval: 24.3-44.1) had a subsequent unscheduled medical visit.


CONCLUSIONS
Infants seen in the ED for bronchiolitis have a prolonged disease course, with substantial burden to the family. Symptom duration may be influenced by a propensity toward atopy. Clinicians may use this information for counseling families.
Petruzella
Frank D
FD
Division of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. fpetruze@mcw.edu
Gorelick
Marc H
MH
D001988:Bronchiolitis / Q000453:epidemiology / Q000534:rehabilitation / Q000821:virology; D017028:Caregivers / Q000193:education; D003376:Counseling; D003877:Dermatitis, Contact / Q000453:epidemiology; D018450:Disease Progression; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D006266:Health Education; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D009819:Office Visits / Q000706:statistics & numerical data; D010290:Parents / Q000193:education; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011368:Professional-Family Relations; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification; D012720:Severity of Illness Index; D013997:Time Factors