Is respiratory viral infection really an important trigger of asthma exacerbations in children?
| Autor: | Hing Sang Wong, Kwok-Hung Chan, Yu-Lung Lau, Peiris Joseph S. Malik, So Lun Lee, Shui Seng Susan Chiu |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Rhinovirus Respiratory Syncytial Virus Infections medicine.disease_cause Severity of Illness Index Exacerbations Cohort Studies Diagnosis Differential Personal hygiene Internal medicine medicine Humans Pediatrics Perinatology and Child Health Prospective Studies Intensive care medicine Prospective cohort study Child Glucocorticoids Respiratory Tract Infections Asthma Original Paper Picornaviridae Infections Respiratory tract infections Pneumovirus business.industry Viral culture Incidence Nebulizers and Vaporizers medicine.disease Trigger Viral infection Spirometry Pediatrics Perinatology and Child Health Cohort Hong Kong Female business Follow-Up Studies |
| Zdroj: | European Journal of Pediatrics |
| ISSN: | 1432-1076 0340-6199 |
| DOI: | 10.1007/s00431-011-1446-1 |
| Popis: | We performed a prospective cohort study from September 2003 to December 2004 to delineate attributing the effect of different respiratory viral infections including newly discovered ones to asthma exacerbations in children in Hong Kong. One hundred and fourteen children aged 6-14 years with chronic stable asthma and on regular inhaled steroid were monitored for respiratory symptoms over a full calendar year from recruitment. They would attend the study clinic if peak expiratory flow rate decreased to below 80% of their baselines, if they met a predefined symptom score, or if parents subjectively felt them developing a cold. Virological diagnosis using virus culture, antigen detection, and polymerase chain reaction methods on nasal swab specimens would be attempted for all these visits irrespective of triggers. Physician diagnosed outcome of each episode was documented. Three hundred and five episodes of respiratory illnesses were captured in the cohort. Nasal specimens were available in 166 episodes, 92 of which were diagnosed as asthma exacerbations, and 74 non-asthma related episodes. Respiratory viruses were detected in 61 of 166 episodes (36.7%). There was no significant difference in virus detection rate between asthma exacerbations (32 out of 97 episodes, 34.8%) and non-asthma respiratory illnesses (29 out of 79 episodes, 39.2%). Although newly discovered respiratory viruses were identified in these episodes, rhinovirus was the commonest organism associated with both asthma exacerbations and non-asthma related episodes. Plausible explanations for much lower virus detection rate than previously reported include improved personal hygiene and precautionary measures taken during respiratory tract infections in the immediate post-severe acute respiratory syndrome period together with a significant contribution of other adverse factors like environmental air pollution. We conclude that not all viral infections in children with asthma lead to an asthma exacerbation and the attributing effect of different triggers of asthma exacerbations in children vary across different time periods and across different localities. © 2011 The Author(s). published_or_final_version Springer Open Choice, 21 Feb 2012 |
| Databáze: | OpenAIRE |
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