The Journal of Allergy and Clinical Immunology
Volume 125, Issue 5 , Pages 1001-1006.e1, May 2010

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

  • Jaime P. Olenec, MD

      Affiliations

    • Department of Pediatrics, University of Wisconsin, Madison, Wis
    • Department of Medicine, University of Wisconsin, Madison, Wis
    • These two authors contributed equally to this study.
    • ,
  • Woo Kyung Kim, MD

      Affiliations

    • Department of Pediatrics, University of Wisconsin, Madison, Wis
    • Department of Pediatrics, Inje University College of Medicine, Seoul, Korea
    • These two authors contributed equally to this study.
    • ,
  • Wai-Ming Lee, PhD

      Affiliations

    • Department of Pediatrics, University of Wisconsin, Madison, Wis
    • ,
  • Fue Vang, MS

      Affiliations

    • Department of Pediatrics, University of Wisconsin, Madison, Wis
    • ,
  • Tressa E. Pappas, BS

      Affiliations

    • Department of Pediatrics, University of Wisconsin, Madison, Wis
    • ,
  • Lisa E.P. Salazar, BA

      Affiliations

    • Department of Pediatrics, University of Wisconsin, Madison, Wis
    • ,
  • Michael D. Evans, MS

      Affiliations

    • Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wis
    • ,
  • Jack Bork, BS

      Affiliations

    • Department of Pediatrics, University of Wisconsin, Madison, Wis
    • ,
  • Kathleen Roberg, RN

      Affiliations

    • Department of Pediatrics, University of Wisconsin, Madison, Wis
    • ,
  • Robert F. Lemanske Jr., MD

      Affiliations

    • Department of Pediatrics, University of Wisconsin, Madison, Wis
    • Department of Medicine, University of Wisconsin, Madison, Wis
    • ,
  • James E. Gern, MD

      Affiliations

    • Department of Pediatrics, University of Wisconsin, Madison, Wis
    • Department of Medicine, University of Wisconsin, Madison, Wis
    • Corresponding Author InformationReprint requests: James E. Gern, MD, University of Wisconsin, K4/918 CSC, 600 Highland Ave, Madison, WI 53792-4108.

Received 4 September 2009; received in revised form 21 January 2010; accepted 25 January 2010. published online 15 April 2010.

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.

Key words: Asthma, children, viral respiratory tract infection, human rhinovirus, allergic sensitization, wheezing, cold symptoms, illness

Abbreviations used: HRV, Human rhinovirus, PEF, Peak expiratory flow

 

 Supported by National Institutes of Health grant R01 HL080072.

 Disclosure of potential conflict of interest: R. F. Lemanske, Jr, has given lectures for Merck and AstraZeneca and has consulted for AstraZeneca, Map Pharmaceuticals, Gray Consulting, Smith Research, Merck Childhood Asthma Network, Novartis, Quintiles/Innovax, RC Horowitz & Co, International Meetings and Science, and Scienomics. J. E. Gern has stock options in EraGen Biosciences and 3V Biosciences, has consulted for 3V Biosciences and Synairgen, and has received research support from AstraZeneca and Merck. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(10)00355-6

doi:10.1016/j.jaci.2010.01.059

The Journal of Allergy and Clinical Immunology
Volume 125, Issue 5 , Pages 1001-1006.e1, May 2010

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