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. 2008 Mar 15;46(6):815-23.
doi: 10.1086/528685.

Viral upper respiratory tract infection and otitis media complication in young children

Tasnee Chonmaitree  1 , Krystal Revai, James J Grady, Audra Clos, Janak A Patel, Sangeeta Nair, Jiang Fan, Kelly J Henrickson
Affiliations

Viral upper respiratory tract infection and otitis media complication in young children

Tasnee Chonmaitree et al. Clin Infect Dis. .

Abstract

Background: The common cold or upper respiratory infection (URI) is highly prevalent among young children and often results in otitis media (OM). The incidence and characteristics of OM complicating URI due to specific viruses have not been well studied.

Methods: We performed a prospective, longitudinal cohort study of 294 healthy children (age range, 6 months to 3 years). Each child was observed for 1 year to assess the occurrence of URI, acute OM (AOM), and OM with effusion (OME) complicating URI due to specific viruses.

Results: We documented 1295 URI episodes (5.06 episodes per child-year) and 440 AOM episodes (1.72 episodes per child-year). Virus studies were performed for 864 URI episodes; 63% were virus positive. Rhinovirus and adenovirus were most frequently detected during URI. The overall incidence of OM that complicated URI was 61%, including a 37% incidence of AOM and a 24% incidence of OME. Young age was the most important predictor of AOM that complicated URI. AOM occurred in approximately one-half of children with URI due to adenovirus, respiratory syncytial virus, or coronavirus and in approximately one-third of those with URI due to influenza virus, parainfluenza virus, enterovirus, or rhinovirus.

Conclusions: More than 60% of episodes of symptomatic URI among young children were complicated by AOM and/or OME. Young age and specific virus types were predictors of URI complicated by AOM. For young children, the strategy to prevent OM should involve prevention of viral URI. The strategy may be more effective if the priority is given to development of means to prevent URI associated with adenovirus and respiratory syncytial virus.

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Figures

Table 1
Table 1
Demographic characteristics and risk factor data at enrollment.
Figure 1
Figure 1
Number of upper respiratory infection (URI) episodes per year in 201 children observed by the study group for an entire 12-month period (mean number of episodes per child, 5.4; median, 5).
Table 2
Table 2
Frequencies of upper respiratory infection (URI) and acute otitis media (AOM) during a 1-year period for 201 children, by age and sex.
Table 3
Table 3
Respiratory viruses detected during 864 episodes of upper respiratory infection.
Figure 2
Figure 2
Day of diagnosis of acute otitis media (AOM) and otitis media with effusion (OME) in the course of upper respiratory infection
Figure 3
Figure 3
Rate of acute otitis media (AOM) and otitis media with effusion (OME) by upper respiratory infection-associated virus, for all virus detection methods combined. RSV, respiratory syncytial virus.
Table 4
Table 4
Rates of acute otitis media (AOM) and new-onset otitis media with effusion (OME) following upper respiratory infection, by respiratory viruses and median age.
Table 5
Table 5
ORs for pair-wise comparisons of the rate of upper respiratory infection complicated by acute otitis media, by specific virus.
Table 6
Table 6
Rates of acute otitis media (AOM) associated with specific viruses, by virus detection method.
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