Long-term airway morbidity following viral LRTI in early infancy: recurrent wheezing or asthma?

Paediatr Respir Rev. 2009 Jun:10 Suppl 1:29-31. doi: 10.1016/S1526-0542(09)70013-2.

Abstract

Episodes of lower respiratory illnesses (LRIs) in the first years of life have been associated with recurrent wheeze in studies of high-risk and community-based cohorts. Respiratory syncytial virus (RSV) is an agent especially associated with severe cases of bronchiolitis affecting young infants in winter months and has a typical seasonal pattern. Data from the Children's Respiratory Study from Arizona and a hospital-based Swedish study have been interpreted as evidence that severe RSV bronchiolitis is associated with a 30-40% likelihood of subsequent asthma. Other respiratory viruses, especially Rhinovirus, have been identified to be importantly associated with recurrent wheeze in children at risk for asthma. A case-control study of palivizumab given in the first year of life to preterm infants has shown a 50% reduction in the occurrence of recurrent wheeze even after controlling for potential confounding variables. Prospective trials with anti-viral strategies, including potential new vaccines, should give us better understanding of the role of viral infections in early life in the causation of childhood asthma.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Asthma / epidemiology*
  • Asthma / etiology
  • Bronchiolitis / complications*
  • Bronchiolitis / virology
  • Humans
  • Infant
  • Morbidity / trends
  • Prognosis
  • Recurrence
  • Respiratory Sounds / etiology*
  • Respiratory Syncytial Virus Infections / complications*
  • Respiratory Syncytial Virus Infections / virology
  • Time Factors