Respiratory picornaviruses and respiratory syncytial virus as causative agents of acute expiratory wheezing in children

Abstract

We studied the viral etiology of acute expiratory wheezing (bronchiolitis, acute asthma) in 293 hospitalized children in a 2-year prospective study in Finland. A potential causative viral agent was detected in 88% of the cases. Eleven different viruses were represented. Respiratory syncytial virus (RSV) (27%), enteroviruses (25%), rhinovirus (24%), and nontypable rhino/enterovirus (16%) were found most frequently. In infants, RSV was found in 54% and respiratory picornaviruses (rhinovirus and enteroviruses) in 42% of the cases. In older children, respiratory picornaviruses dominated (65% of children ages 1-2 years and 82% of children ages > or =3 years). Human metapneumovirus was detected in 4% of all children and in 11% of infants. To prevent and treat acute expiratory wheezing illnesses in children, efforts should be focused on RSV, enterovirus, and rhinovirus infections.

Figure 1

Hospitalized children with expiratory wheezing during the study period. Black indicates included patients.

Figure 2

The epidemics of respiratory syncytial virus (red), rhinovirus (blue), enterovirus (green), and human metapneumovirus (brown) during the study period.

Figure 3

The prevalence of respiratory viruses in hospitalized, wheezing children in different age groups. RSV, respiratory syncytial virus; RHINO, rhinovirus; RHI-ENT, rhino/enterovirus; ENTERO, enteroviruses; HMPV, human metapneumovirus; PARA 1–3, parainfluenza virus types 1–3; INFLU A/B, influenza A and B viruses; ADENO, adenovirus; CORONA, coronavirus; MIXED, mixed viral infection. p values are for intergroup comparisons: RSV p < 0.001, HMPV p = 0.003, enteroviruses p = 0.0018, and adenovirus p = 0.022.