Wheezing, asthma, and pulmonary dysfunction 10 years after infection with respiratory syncytial virus in infancy.

Abstract

Of the 180 children admitted to hospitals in Tyneside in the first year of life with proved respiratory syncytial virus lower respiratory tract infection, 130 were seen for review 10 years later and 34 of the remaining 50 children accounted for. Skin tests, lung function tests, and histamine-challenge and exercise tests for bronchial lability were undertaken in over 100 of the index children and a similar number of control children. A total of 55 (42%) of the 130 index children had had further episodes of wheeze, while only 21 (19%) out of 111 controls had ever wheezed; but few (6-2% v 4-5%) had troublesome symptoms at the age of 10. There was a threefold increase in the incidence of bronchial lability in the index children but no excess of atopy. Maximum expiratory air flow was reduced throughout the vital capacity manoeuvre in the index children, even when those with a history of recurrent wheeze were excluded. Results of single-breath nitrogen washout tests were normal, however, suggesting that ventilation was not appreciably uneven, even though expiratory flow was restricted. These differences might have been caused by infection damaging the growing lung but might also be explained by pre-existing differences in the airway, rendering certain children more susceptible to symptomatic infection when first challenged by the virus in infancy.

Epidemiology and aetiology of acute bronchiolitis in Hong Kong infants

“…This observation is in agreement with the general consensus that recurrent wheezing after acute bronchiolitis in infancy is common [15][16][17][18]. Thirteen of the 119 patients had four or more admissions under the same diagnosis, 'acute bronchiolitis'.…”

Prevalence of respiratory symptoms, bronchial hyperresponsiveness and atopy among adults: west and east Germany

“…The average number of siblings in East Germany was higher than in West Germany, thus supporting the observation of VON MUTIUS et al [26], who described a decreasing trend of atopic sensitization with an increasing number of siblings. Although subjects from Eastern Germany had more frequently attended a playschool or nursery, no significant differences were reported regarding serious respiratory tract infections which may predispose to impaired lung function [36], but not necessarily to atopy [37]. Since adjusting for the number of siblings did not significantly alter the odds ratio of positive skin tests, specific IgE values or bronchial hyperresponsiveness between the two cities, this does not seem to be a relevant confounder for the observed difference.…”

Hospitalização por bronquiolite aguda como fator de risco para sibilância recorrente

“…Embora a literatura mostre que meninos sibilam mais do que as meninas (Pullan & Hey, 1982;Welliver et al, 1986a), tal associação não foi aqui demonstrada. Panitch et al (1993) apontaram história familiar de asma e de atopia como fatores de risco para sibilância recorrente pós-bronquiolite.…”

“…Fatores relacionados à aglomeração -tais como "número de pessoas no quarto da criança", "presença de outra criança menor de cinco anos na residência" e "tamanho da família" -têm sido citados como de risco para aumentar a exposição a vírus (Pullan & Hey, 1982). Estes fatores têm sido mais apontados como de risco para a hospitalização por bronquiolite, mas pouco avaliados para sibilância recorrente.…”