Weekly monitoring of children with asthma for infections and illness during common cold seasons

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:125

Article

Olenec, Jaime P.^1,2  Kim, Woo Kyung^1,4  Lee, Wai-Ming¹  Vang, Fue¹  Pappas, Tressa E.¹  Salazar, Lisa E. P.¹  Evans, Michael D.³  Bork, Jack¹  Roberg, Kathleen¹  Lemanske, Robert F., Jr.^1,2  Gern, James E.^1,2 

[1] Univ Wisconsin, Dept Pediat, Madison, WI 53792 USA

[2] Univ Wisconsin, Dept Med, Madison, WI 53792 USA

[3] Univ Wisconsin, Dept Biostat & Med Informat, Madison, WI 53792 USA

[4] Inje Univ, Coll Med, Dept Pediat, Seoul, South Korea

关键词: Asthma;    children;    viral respiratory tract infection;    human rhinovirus;    allergic sensitization;    wheezing;    cold symptoms;    illness;   

DOI  :  10.1016/j.jaci.2010.01.059

来源: Elsevier

【 摘 要 】

Background: Exacerbations of childhood asthma and rhinovirus infections both peak during the spring and fall, suggesting that viral infections are major contributors to seasonal asthma morbidity. Objectives: We sought to evaluate rhinovirus infections during peak seasons in children with asthma and to analyze relationships between viral infection and illness severity. Methods: Fifty-eight children aged 6 to 8 years with asthma provided 5 consecutive weekly nasal lavage samples during September and April; symptoms, medication use, and peak flow were recorded. Rhinoviruses were identified by using multiplex PCR and partial sequencing of viral genomes. Results: Viruses were detected in 36% to 50% of the specimens, and 72% to 99% of the viruses were rhinoviruses. There were 52 different strains (including 16 human rhinovirus C) among the 169 rhinovirus isolates; no strains were found in more than 2 collection periods, and all but 2 children had a respiratory tract infection. Virus-positive weeks were associated with greater cold and asthma symptom severity (P <.0001 and P = .0002, respectively). Furthermore, virus-positive illnesses had increased duration and severity of cold and asthma symptoms and more frequent loss of asthma control (47% vs 22%, P = .008). Although allergen-sensitized versus nonsensitized children had the same number of viral infections, the former had 47% more symptomatic viral illnesses (1.19 vs 0.81 per month, P = .03). Conclusions: Rhinovirus infections are nearly universal in children with asthma during common cold seasons, likely because of a plethora of new strains appearing each season. Illnesses associated with viruses have greater duration and severity. Finally, atopic asthmatic children experienced more frequent and severe virus-induced illnesses. (J Allergy Clin Immunol 2010;125:1001-6.)

【 授权许可】

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