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Article: Is respiratory viral infection really an important trigger of asthma exacerbations in children?

TitleIs respiratory viral infection really an important trigger of asthma exacerbations in children?
Authors
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
Citation
European Journal Of Pediatrics, 2011, v. 170 n. 10, p. 1317-1324 How to Cite?
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).
Persistent Identifierhttp://hdl.handle.net/10722/145105
ISSN
2014 Impact Factor: 1.890
2014 SCImago Journal Rankings: 0.726
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Research Grants Council of Hong KongHKU763707M
Funding Information:

Research Grants Council of Hong Kong (HKU763707M)

References

 

DC FieldValueLanguage
dc.contributor.authorLee, SLen_HK
dc.contributor.authorChiu, SSSen_HK
dc.contributor.authorMalik, PJSen_HK
dc.contributor.authorChan, KHen_HK
dc.contributor.authorWong, HSWen_HK
dc.contributor.authorLau, YLen_HK
dc.date.accessioned2012-02-21T05:44:39Z-
dc.date.available2012-02-21T05:44:39Z-
dc.date.issued2011en_HK
dc.identifier.citationEuropean Journal Of Pediatrics, 2011, v. 170 n. 10, p. 1317-1324en_HK
dc.identifier.issn0340-6199en_HK
dc.identifier.urihttp://hdl.handle.net/10722/145105-
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).en_HK
dc.languageengen_US
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00431/index.htmen_HK
dc.relation.ispartofEuropean Journal of Pediatricsen_HK
dc.rightsThe Author(s)en_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong Licenseen_US
dc.subjectAsthmaen_HK
dc.subjectExacerbationsen_HK
dc.subjectTriggeren_HK
dc.subjectViral infectionen_HK
dc.titleIs respiratory viral infection really an important trigger of asthma exacerbations in children?en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4551/resserv?sid=springerlink&genre=article&atitle=Is respiratory viral infection really an important trigger of asthma exacerbations in children?&title=European Journal of Pediatrics&issn=03406199&date=2011-10-01&volume=170&issue=10& spage=1317&authors=So-lun Lee, Shui-seng Susan Chiu, Peiris Joseph S. Malik, <i>et al.</i>en_US
dc.identifier.emailChiu, SSS:ssschiu@hkucc.hku.hken_HK
dc.identifier.emailLau, YL:lauylung@hkucc.hku.hken_HK
dc.identifier.authorityChiu, SSS=rp00421en_HK
dc.identifier.authorityLau, YL=rp00361en_HK
dc.description.naturepublished_or_final_versionen_US
dc.identifier.doi10.1007/s00431-011-1446-1en_HK
dc.identifier.pmid21448631-
dc.identifier.pmcidPMC3175036-
dc.identifier.scopuseid_2-s2.0-80054749681en_HK
dc.identifier.hkuros187583-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80054749681&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume170en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1317en_HK
dc.identifier.epage1324en_HK
dc.identifier.eissn1432-1076en_US
dc.identifier.isiWOS:000294960000012-
dc.publisher.placeGermanyen_HK
dc.description.otherSpringer Open Choice, 21 Feb 2012en_US
dc.identifier.scopusauthoridLee, SL=53863772000en_HK
dc.identifier.scopusauthoridChiu, SSS=7202291500en_HK
dc.identifier.scopusauthoridMalik, PJS=37054131600en_HK
dc.identifier.scopusauthoridChan, KH=7406034307en_HK
dc.identifier.scopusauthoridWong, HSW=53864368300en_HK
dc.identifier.scopusauthoridLau, YL=7201403380en_HK
dc.identifier.citeulike9112077-

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