Hyaline membrane disease, or infantile respiratory distress syndrome, is a lung disease that occurs only in very premature babies. The more premature the infant, the greater the risk of developing the condition. Of babies born 8 weeks premature, 75% will be affected.
Surfactant is a fluid essential within the lungs to enable them to open and fill with air after birth. It is not produced in adequate quantity in some premature babies, so their lungs do not open and they cannot obtain sufficient air and oxygen. The hyaline membrane that lines the tiny airways within the lungs is responsible for producing surfactant. Hyaline membranes are not anatomical structures but restrictive membranes, formed by proteins exuded from the tiny blood vessels in the immature lungs of premature babies, which decrease the elasticity of the lungs and make breathing more difficult.
The condition develops some hours after birth, when the baby starts to breath rapidly, grunt with each breath, and has very marked movements of the chest and abdomen as it tries to breath. The baby will become blue in colour, and lapse into a coma.
The diagnosis is confirmed by a chest X-ray while a special test performed on a sample of the amniotic fluid in which the baby floats in the womb can assess the risk of developing the disease before birth. It can be prevented if the mother is given an injection of a steroid at least 48 hours before the birth. Every effort is made to delay a birth until the 48 hours has elapsed.
Once the disease is present, oxygen is given in a humidicrib. Death is common without treatment, but if the baby survives for 48 hours, it is almost certain to recover. A small number of children have permanent lung damage.
See also PREMATURE BABY
The respiratory syncitial virus (RSV) is a myxovirus that is responsible for bronchiolitis in infants and the common cold and bronchitis in older children and adults.
See also BRONCHIOLITIS; BRONCHITIS; COLD, COMMON; MYXOVIRUS; VIRUS
Reye syndrome is a rare brain and liver inflammation that is more common in children under six years of age, and is named after the Australian pathologist (Douglas Reye, 1912 to 1977) who first described it. The cause is unknown, but it may be associated with the use of aspirin in children. It invariably follows two to three weeks after a viral infection such as influenza, chickenpox or a cold.
Liver failure and brain inflammation (encephalitis) occur, that cause vomiting, mental confusion and convulsions.
No specific treatment is available, but attempts are made to control the brain swelling and assist breathing. There is a death rate in excess of 30% and it is often rapidly fatal. Permanent liver or brain damage may occur in survivors.
See also ENCEPHALITIS
Roseola infantum (baby measles, sixth disease or exanthema subitum) is a contagious viral infection that is caught by virtually every child in the first two or three years of life. It has an incubation period from 7 to 17 days, and most children will have such a mild attack that it will be passed off as a slight cold. Those with a severe attack will develop a fever and a measles-like rash on the trunk and neck, which usually appears after the fever has gone.
No treatment is necessary other than paracetamol for the fever, and the child recovers completely within two or three days.
See also GERMAN MEASLES; MEASLES; VIRUS
The rotavirus is responsible for many cases of gastroenteritis, particularly in children. It is named because of it appears like a rotating spoked wheel when seen under an electron microscope. It spreads from the faeces of one person to the mouth of another to continue its infective cycle. Many animals may also act as a reservoir of infection.
See also GASTROENTERITIS; VIRUS RUBELLA
See GERMAN MEASLES