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

Jaime P. Olenec, Woo Kyung Kim, Wai Ming Lee, Fue Vang, Tressa E. Pappas, Lisa E.P. Salazar, Michael D. Evans, Jack Bork, Kathleen Roberg, Robert F. Lemanske, James E. Gern

Research output: Contribution to journalArticlepeer-review

136 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1001-1006.e1
JournalJournal of Allergy and Clinical Immunology
Volume125
Issue number5
DOIs
StatePublished - May 2010
Externally publishedYes

Keywords

  • Asthma
  • allergic sensitization
  • children
  • cold symptoms
  • human rhinovirus
  • illness
  • viral respiratory tract infection
  • wheezing

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