Recurrent Wheezing in Infants and Young Children and Bronchial Hyper- Responsiveness

Childhood wheeze is a common phenomenon, and has seasonal prominence, largely focused on a viral respiratory syncytial infection (RSV). When children wheeze again, or repeatedly, and a RSV infection was previously documented, a ready explanation is available. Recent data strongly supports the likelihood of rhinovirus as the agent for the next sequence wheeze, and with the recurrent wheeze a risk for asthma development [2]. Without a RSV vaccination this postbronchiolitis wheezer will fit the profile offered in the original review. There remains however, as mentioned in 2003, a concern these postbronchiolitis wheezers can morph into asthma, and a recent study suggest a genetic association [3]. This “phenotype” was more recently discussed, but termed “severe intermittent wheeze” [4]. Atopic features and eventual asthma, however was not uncommon in the phenotype discussed. It seems the medical community in 2016 still struggles with the post-RSV phenotype.