Title Weekly monitoring of children with asthma for infections and illness during common cold seasons.
Author Olenec, Jaime P; Kim, Woo Kyung; Lee, Wai-Ming; Vang, Fue; Pappas, Tressa E; Salazar, Lisa E P; Evans, Michael D; Bork, Jack; Roberg, Kathleen; Lemanske, Robert F Jr; Gern, James E
Journal J Allergy Clin Immunol Publication Year/Month 2010-May
PMID 20392488 PMCID PMC2866802
Affiliation 1.Department of Pediatrics, University of Wisconsin, Madison, WI 53792-4108, USA.

BACKGROUND: Exacerbations of childhood asthma and rhinovirus infections both peak during the spring and fall, suggesting that viral infections are major contributors to seasonal asthma morbidity. OBJECTIVES: We sought to evaluate rhinovirus infections during peak seasons in children with asthma and to analyze relationships between viral infection and illness severity. METHODS: Fifty-eight children aged 6 to 8 years with asthma provided 5 consecutive weekly nasal lavage samples during September and April; symptoms, medication use, and peak flow were recorded. Rhinoviruses were identified by using multiplex PCR and partial sequencing of viral genomes. RESULTS: Viruses were detected in 36% to 50% of the specimens, and 72% to 99% of the viruses were rhinoviruses. There were 52 different strains (including 16 human rhinovirus C) among the 169 rhinovirus isolates; no strains were found in more than 2 collection periods, and all but 2 children had a respiratory tract infection. Virus-positive weeks were associated with greater cold and asthma symptom severity (P < .0001 and P = .0002, respectively). Furthermore, virus-positive illnesses had increased duration and severity of cold and asthma symptoms and more frequent loss of asthma control (47% vs 22%, P = .008). Although allergen-sensitized versus nonsensitized children had the same number of viral infections, the former had 47% more symptomatic viral illnesses (1.19 vs 0.81 per month, P = .03). CONCLUSIONS: Rhinovirus infections are nearly universal in children with asthma during common cold seasons, likely because of a plethora of new strains appearing each season. Illnesses associated with viruses have greater duration and severity. Finally, atopic asthmatic children experienced more frequent and severe virus-induced illnesses.

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