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Article: Is respiratory viral infection really an important trigger of asthma exacerbations in children?
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TitleIs respiratory viral infection really an important trigger of asthma exacerbations in children?
 
AuthorsLee, SL1
Chiu, SSS1
Malik, PJS1
Chan, KH1
Wong, HSW1
Lau, YL1
 
KeywordsAsthma
Exacerbations
Trigger
Viral infection
 
Issue Date2011
 
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00431/index.htm
 
CitationEuropean Journal Of Pediatrics, 2011, v. 170 n. 10, p. 1317-1324 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00431-011-1446-1
 
AbstractWe performed a prospective cohort study from September 2003 to December 2004 to delineate attributing the effect of different respiratory viral infections including newly discovered ones to asthma exacerbations in children in Hong Kong. One hundred and fourteen children aged 6-14 years with chronic stable asthma and on regular inhaled steroid were monitored for respiratory symptoms over a full calendar year from recruitment. They would attend the study clinic if peak expiratory flow rate decreased to below 80% of their baselines, if they met a predefined symptom score, or if parents subjectively felt them developing a cold. Virological diagnosis using virus culture, antigen detection, and polymerase chain reaction methods on nasal swab specimens would be attempted for all these visits irrespective of triggers. Physician diagnosed outcome of each episode was documented. Three hundred and five episodes of respiratory illnesses were captured in the cohort. Nasal specimens were available in 166 episodes, 92 of which were diagnosed as asthma exacerbations, and 74 non-asthma related episodes. Respiratory viruses were detected in 61 of 166 episodes (36.7%). There was no significant difference in virus detection rate between asthma exacerbations (32 out of 97 episodes, 34.8%) and non-asthma respiratory illnesses (29 out of 79 episodes, 39.2%). Although newly discovered respiratory viruses were identified in these episodes, rhinovirus was the commonest organism associated with both asthma exacerbations and non-asthma related episodes. Plausible explanations for much lower virus detection rate than previously reported include improved personal hygiene and precautionary measures taken during respiratory tract infections in the immediate post-severe acute respiratory syndrome period together with a significant contribution of other adverse factors like environmental air pollution. We conclude that not all viral infections in children with asthma lead to an asthma exacerbation and the attributing effect of different triggers of asthma exacerbations in children vary across different time periods and across different localities. © 2011 The Author(s).
 
ISSN0340-6199
2013 Impact Factor: 1.983
 
DOIhttp://dx.doi.org/10.1007/s00431-011-1446-1
 
PubMed Central IDPMC3175036
 
ISI Accession Number IDWOS:000294960000012
Funding AgencyGrant Number
Research Grants Council of Hong KongHKU763707M
Funding Information:

Research Grants Council of Hong Kong (HKU763707M)

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLee, SL
 
dc.contributor.authorChiu, SSS
 
dc.contributor.authorMalik, PJS
 
dc.contributor.authorChan, KH
 
dc.contributor.authorWong, HSW
 
dc.contributor.authorLau, YL
 
dc.date.accessioned2012-02-21T05:44:39Z
 
dc.date.available2012-02-21T05:44:39Z
 
dc.date.issued2011
 
dc.description.abstractWe performed a prospective cohort study from September 2003 to December 2004 to delineate attributing the effect of different respiratory viral infections including newly discovered ones to asthma exacerbations in children in Hong Kong. One hundred and fourteen children aged 6-14 years with chronic stable asthma and on regular inhaled steroid were monitored for respiratory symptoms over a full calendar year from recruitment. They would attend the study clinic if peak expiratory flow rate decreased to below 80% of their baselines, if they met a predefined symptom score, or if parents subjectively felt them developing a cold. Virological diagnosis using virus culture, antigen detection, and polymerase chain reaction methods on nasal swab specimens would be attempted for all these visits irrespective of triggers. Physician diagnosed outcome of each episode was documented. Three hundred and five episodes of respiratory illnesses were captured in the cohort. Nasal specimens were available in 166 episodes, 92 of which were diagnosed as asthma exacerbations, and 74 non-asthma related episodes. Respiratory viruses were detected in 61 of 166 episodes (36.7%). There was no significant difference in virus detection rate between asthma exacerbations (32 out of 97 episodes, 34.8%) and non-asthma respiratory illnesses (29 out of 79 episodes, 39.2%). Although newly discovered respiratory viruses were identified in these episodes, rhinovirus was the commonest organism associated with both asthma exacerbations and non-asthma related episodes. Plausible explanations for much lower virus detection rate than previously reported include improved personal hygiene and precautionary measures taken during respiratory tract infections in the immediate post-severe acute respiratory syndrome period together with a significant contribution of other adverse factors like environmental air pollution. We conclude that not all viral infections in children with asthma lead to an asthma exacerbation and the attributing effect of different triggers of asthma exacerbations in children vary across different time periods and across different localities. © 2011 The Author(s).
 
dc.description.naturepublished_or_final_version
 
dc.description.otherSpringer Open Choice, 21 Feb 2012
 
dc.identifier.citationEuropean Journal Of Pediatrics, 2011, v. 170 n. 10, p. 1317-1324 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00431-011-1446-1
 
dc.identifier.citeulike9112077
 
dc.identifier.doihttp://dx.doi.org/10.1007/s00431-011-1446-1
 
dc.identifier.eissn1432-1076
 
dc.identifier.epage1324
 
dc.identifier.hkuros187583
 
dc.identifier.isiWOS:000294960000012
Funding AgencyGrant Number
Research Grants Council of Hong KongHKU763707M
Funding Information:

Research Grants Council of Hong Kong (HKU763707M)

 
dc.identifier.issn0340-6199
2013 Impact Factor: 1.983
 
dc.identifier.issue10
 
dc.identifier.openurl
 
dc.identifier.pmcidPMC3175036
 
dc.identifier.pmid21448631
 
dc.identifier.scopuseid_2-s2.0-80054749681
 
dc.identifier.spage1317
 
dc.identifier.urihttp://hdl.handle.net/10722/145105
 
dc.identifier.volume170
 
dc.languageEng
 
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00431/index.htm
 
dc.publisher.placeGermany
 
dc.relation.ispartofEuropean Journal of Pediatrics
 
dc.relation.referencesReferences in Scopus
 
dc.rightsThe Author(s)
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subjectAsthma
 
dc.subjectExacerbations
 
dc.subjectTrigger
 
dc.subjectViral infection
 
dc.titleIs respiratory viral infection really an important trigger of asthma exacerbations in children?
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong