Community study of role of viral infections in exacerbations of asthma in 9-11 year old children

Abstract

Objective: To study the association between upper and lower respiratory viral infections and acute exacerbations of asthma in schoolchildren in the community.

Design: Community based 13 month longitudinal study using diary card respiratory symptom and peak expiratory flow monitoring to allow early sampling for viruses.

Subjects: 108 Children aged 9-11 years who had reported wheeze or cough, or both, in a questionnaire.

Setting: Southampton and surrounding community.

Main outcome measures: Upper and lower respiratory viral infections detected by polymerase chain reaction or conventional methods, reported exacerbations of asthma, computer identified episodes of respiratory tract symptoms or peak flow reductions.

Results: Viruses were detected in 80% of reported episodes of reduced peak expiratory flow, 80% of reported episodes of wheeze, and in 85% of reported episodes of upper respiratory symptoms, cough, wheeze, and a fall in peak expiratory flow. The median duration of reported falls in peak expiratory flow was 14 days, and the median maximum fall in peak expiratory flow was 81 l/min. The most commonly identified virus type was rhinovirus.

Conclusions: This study supports the hypothesis that upper respiratory viral infections are associated with 80-85% of asthma exacerbations in school age children.