SELECTED ARTICLES FROM THE RECENT LITERATURE 2005
9/20/05
Rhinovirus infection in infancy as a risk factor for asthma
Summary
Background - Respiratory syncytial virus (RSV) infections leading to bronchiolitis in infants has been frequently implicated as a risk factor for subsequent wheezing in childhood. Most recent findings have suggested that infections with other viruses (metapneumovirus and rhinovirus {RV]) may play roles in causing bronchiolitis.
Findings - Lemanske et al of the Univ of Wisconsin extended these findings. They found that moderate to severe respiratory illnesses caused by RV were the most impressive risk factor for the subsequent development of persistent wheezing in pre-school children (Odd Ratio = 6.6; p<0.0001). Of infants who wheezed during the usual RV seasons, 63% continued to wheeze for at least the third year of life.
Reference
J Allergy Clin Immunol 2005;116:571-7
Editor's Comments
These findings strongly suggest that lower respiratory tract RV infections in infancy seem to predispose to subsequent recurrent wheezing, in pre-school children at least. It remains to be seen whether such subsequent wheezing remits (as it often does) or continues past age 4 years. On would like to know whether a parental history of asthma was present in those children who wheezed recurrently after an episode of RV infection in infancy.
The RV group of viruses is the most common cause of upper respiratory infections in adolescent/adults but typically does not cause wheezing bronchial infections in this age group. It appears that a different pattern of disease may be caused by RV infection in infants.
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