RHINOVIRUS AS A
CAUSE OF WHEEZING ILLNESSES IN THE FIRST YEAR OF LIFE
Kunling Shen1, KA
Anklam2, KA Roberg2, KT Carlson-Dakes2, K Adler2,
PA Shult2, CJ Kirk2,
DF Da Silva2, SA Ellerman2, L Zeng2, RF Lemanske Jr2, JE Gern2.
1Beijing Children's
Hospital, Beijing, China
2University of
Wisconsin-Madison, USA
Objective: Rhinovirus (RV) infections can cause
wheezing illnesses in children and adults with asthma, but there is little
information regarding the relationship of RV infections to wheezing in infancy. We hypothesized that RV infections
could induce wheezing illnesses in infants at increased risk of developing
allergy and asthma.
Methods: The study included 165 infants enrolled
in the COAST (Childhood Origins of Asthma) study who each had at least one
parent with allergy or asthma. The infants were evaluated from birth until
age 1 year, during which 1019 nasal washings were collected from 1/15/99 -
9/30/00 during well child visits, and during times of acute symptomatic
respiratory tract illnesses. Results from viral culture and RV-specific
RT-PCR were compared to clinical symptom scores at the initial illness
evaluation.
Results: RV was detected by either culture or
RT-PCR in 206 of the 377 (55%) of samples from symptomatic infants, and was
the most common cause of respiratory illness in these infants. Although the majority of illnesses
caused by RV were colds, parents reported that 27% of the infections were
associated with wheezing, and 4.9% were associated with dyspnea.
Conclusions: Although most of the RV infections
were relatively mild, a subset of RV infections were accompanied by
wheezing, and had symptoms which overlapped with lower airway syndromes
such as bronchiolitis. These findings raise the possibility that RV can
induce wheezing illnesses in high-risk children even before the clinical
onset of asthma.