Is respiratory viral infection really an important trigger of asthma exacerbations in children?
Identifieur interne : 002269 ( Main/Exploration ); précédent : 002268; suivant : 002270Is respiratory viral infection really an important trigger of asthma exacerbations in children?
Auteurs : So-Lun Lee [République populaire de Chine, Hong Kong] ; Shui-Seng Susan Chiu [République populaire de Chine, Hong Kong] ; Peiris Joseph S. Malik [République populaire de Chine, Hong Kong] ; Kwok-Hung Chan [République populaire de Chine, Hong Kong] ; Hing-Sang Wilfred Wong [République populaire de Chine, Hong Kong] ; Yu-Lung Lau [République populaire de Chine, Hong Kong]Source :
- European Journal of Pediatrics [ 0340-6199 ] ; 2011-10-01.
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Abstract
Abstract: We 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.
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DOI: 10.1007/s00431-011-1446-1
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Malik</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Microbiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR</wicri:regionArea><wicri:noRegion>SAR</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Hong Kong</country></affiliation></author><author><name sortKey="Chan, Kwok Hung" sort="Chan, Kwok Hung" uniqKey="Chan K" first="Kwok-Hung" last="Chan">Kwok-Hung Chan</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Microbiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR</wicri:regionArea><wicri:noRegion>SAR</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Hong Kong</country></affiliation></author><author><name sortKey="Wong, Hing Sang Wilfred" sort="Wong, Hing Sang Wilfred" uniqKey="Wong H" first="Hing-Sang Wilfred" last="Wong">Hing-Sang Wilfred Wong</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR</wicri:regionArea><wicri:noRegion>SAR</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Hong Kong</country></affiliation></author><author><name sortKey="Lau, Yu Lung" sort="Lau, Yu Lung" uniqKey="Lau Y" first="Yu-Lung" last="Lau">Yu-Lung Lau</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR</wicri:regionArea><wicri:noRegion>SAR</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Hong Kong</country></affiliation></author></analytic><monogr></monogr><series><title level="j">European Journal of Pediatrics</title><title level="j" type="abbrev">Eur J Pediatr</title><idno type="ISSN">0340-6199</idno><idno type="eISSN">1432-1076</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="2011-10-01">2011-10-01</date><biblScope unit="volume">170</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1317">1317</biblScope><biblScope unit="page" to="1324">1324</biblScope></imprint><idno type="ISSN">0340-6199</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0340-6199</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Asthma</term><term>Exacerbations</term><term>Trigger</term><term>Viral infection</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: We 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.</div></front></TEI><affiliations><list><country><li>Hong Kong</li><li>République populaire de Chine</li></country></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Lee, So Lun" sort="Lee, So Lun" uniqKey="Lee S" first="So-Lun" last="Lee">So-Lun Lee</name></noRegion><name sortKey="Chan, Kwok Hung" sort="Chan, Kwok Hung" uniqKey="Chan K" first="Kwok-Hung" last="Chan">Kwok-Hung Chan</name><name sortKey="Chiu, Shui Seng Susan" sort="Chiu, Shui Seng Susan" uniqKey="Chiu S" first="Shui-Seng Susan" last="Chiu">Shui-Seng Susan Chiu</name><name sortKey="Lau, Yu Lung" sort="Lau, Yu Lung" uniqKey="Lau Y" first="Yu-Lung" last="Lau">Yu-Lung Lau</name><name sortKey="Malik, Peiris Joseph S" sort="Malik, Peiris Joseph S" uniqKey="Malik P" first="Peiris Joseph S." last="Malik">Peiris Joseph S. Malik</name><name sortKey="Wong, Hing Sang Wilfred" sort="Wong, Hing Sang Wilfred" uniqKey="Wong H" first="Hing-Sang Wilfred" last="Wong">Hing-Sang Wilfred Wong</name></country><country name="Hong Kong"><noRegion><name sortKey="Lee, So Lun" sort="Lee, So Lun" uniqKey="Lee S" first="So-Lun" last="Lee">So-Lun Lee</name></noRegion><name sortKey="Chan, Kwok Hung" sort="Chan, Kwok Hung" uniqKey="Chan K" first="Kwok-Hung" last="Chan">Kwok-Hung Chan</name><name sortKey="Chiu, Shui Seng Susan" sort="Chiu, Shui Seng Susan" uniqKey="Chiu S" first="Shui-Seng Susan" last="Chiu">Shui-Seng Susan Chiu</name><name sortKey="Lau, Yu Lung" sort="Lau, Yu Lung" uniqKey="Lau Y" first="Yu-Lung" last="Lau">Yu-Lung Lau</name><name sortKey="Malik, Peiris Joseph S" sort="Malik, Peiris Joseph S" uniqKey="Malik P" first="Peiris Joseph S." last="Malik">Peiris Joseph S. Malik</name><name sortKey="Wong, Hing Sang Wilfred" sort="Wong, Hing Sang Wilfred" uniqKey="Wong H" first="Hing-Sang Wilfred" last="Wong">Hing-Sang Wilfred Wong</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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