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
2011 Impact Factor: 1.879
2011 SCImago Journal Rankings: 0.135
DOIhttp://dx.doi.org/10.1007/s00431-011-1446-1
PubMed Central IDPMC3175036
ReferencesReferences in Scopus
DC Field
Value
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
2011 Impact Factor: 1.879
2011 SCImago Journal Rankings: 0.135
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
Author Affiliations
  1. The University of Hong Kong