The Journal of Allergy and Clinical Immunology
Volume 119, Issue 2 , Pages 314-321, February 2007

Prevalence of viral respiratory tract infections in children with asthma

  • Nino Khetsuriani, MD, PhD

      Affiliations

    • From the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention
    • ,
  • N. Neely Kazerouni, DrPH

      Affiliations

    • Air Pollution and Respiratory Health Branch, Division of Environmental Hazard and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention
    • ,
  • Dean D. Erdman, DrPH

      Affiliations

    • From the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention
    • ,
  • Xiaoyan Lu, MS

      Affiliations

    • From the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention
    • ,
  • Stephen C. Redd, MD

      Affiliations

    • Air Pollution and Respiratory Health Branch, Division of Environmental Hazard and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention
    • ,
  • Larry J. Anderson, MD

      Affiliations

    • From the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention
    • ,
  • W. Gerald Teague, MD

      Affiliations

    • Division of Pulmonary, Allergy, Cystic Fibrosis, and Sleep Medicine, Department of Pediatrics, Emory University School of Medicine
    • Corresponding Author InformationReprint requests: W. Gerald Teague, MD, Department of Pediatrics, Emory Pediatrics, 2015 Uppergate Dr, Atlanta, GA 30322.

Received 19 December 2005; received in revised form 9 August 2006; accepted 15 August 2006. published online 12 December 2006.

Atlanta, Ga

Background

Previous studies support a strong association between viral respiratory tract infections and asthma exacerbations. The effect of newly discovered viruses on asthma control is less well defined.

Objective

We sought to determine the contribution of respiratory viruses to asthma exacerbations in children with a panel of PCR assays for common and newly discovered respiratory viruses.

Methods

Respiratory specimens from children aged 2 to 17 years with asthma exacerbations (case patients, n = 65) and with well-controlled asthma (control subjects, n = 77), frequency matched by age and season of enrollment, were tested for rhinoviruses, enteroviruses, respiratory syncytial virus, human metapneumovirus, coronaviruses 229E and OC43, parainfluenza viruses 1 to 3, influenza viruses, adenoviruses, and human bocavirus.

Results

Infection with respiratory viruses was associated with asthma exacerbations (63.1% in case patients vs 23.4% in control subjects; odds ratio, 5.6; 95% CI, 2.7- 11.6). Rhinovirus was by far the most prevalent virus (60% among case patients vs 18.2% among control subjects) and the only virus significantly associated with exacerbations (odds ratio, 6.8; 95% CI, 3.2-14.5). However, in children without clinically manifested viral respiratory tract illness, the prevalence of rhinovirus infection was similar in case patients (29.2%) versus control subjects (23.4%, P > .05). Other viruses detected included human metapneumovirus (4.6% in patients with acute asthma vs 2.6% in control subjects), enteroviruses (4.6% vs 0%), coronavirus 229E (0% vs 1.3%), and respiratory syncytial virus (1.5% vs 0%).

Conclusion

Symptomatic rhinovirus infections are an important contributor to asthma exacerbations in children.

Clinical implications

These results support the need for therapies effective against rhinovirus as a means to decrease asthma exacerbations.

Key words: Respiratory viruses, asthma, asthma exacerbation, case-control study, PCR, rhinovirus

Abbreviations used: HMPV, Human metapneumovirus, OR, Odds ratio, RSV, Respiratory syncytial virus

 

 Part of this study was presented and published in abstract form at the 2004 meeting of the American Thoracic Society in Orlando, Florida, and was supported by the National Center for Environmental Health, Centers for Disease Control and Prevention, Contract 200-1998-00103.Disclosure of potential conflict of interest: W. G. Teague is on the speakers' bureau for Merck and Co. N. N. Kazerouni has received grant support from the National Center for Environmental Health and the Centers for Disease Control and Prevention. The rest of the authors have declared that they have no conflict of interest.The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

PII: S0091-6749(06)02129-4

doi:10.1016/j.jaci.2006.08.041

The Journal of Allergy and Clinical Immunology
Volume 119, Issue 2 , Pages 314-321, February 2007

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