RHINOVIRUS INDUCED WHEEZING IN INFANCY CARRIES A RISK FOR ASTHMA

Kotaniemi-Syrjänen A1, Vanionpää R2, Reijonen T1, Korppi M1

1Department of Pediatrics, Kuopio University Hospital,  and 2Department of Virology, Turku University, Finland.

One hundred children hospitalized for wheezing under 2 years of age were enrolled in 1992-1993. The children were prospectively followed-up; 87 of them attended the control visit 3 years after hospitalization and 82 at the age of  6 to 8 years in 1999.

Nasopharyngeal aspirates were obtained on admission in all cases, and in 2000, frozen samples were available in 81 cases for rhinovirus, enterovirus and coronavirus detection by PCR. RSV was found in 22 cases, and the presence of RSV was associated with a low risk for later asthma (1). Rhinovirus was identified in 27(33%), enterovirus in 10(12%), and coronavirus no children. The mean age was 14 months in rhinovirus-positive and 9 months in rhinovirus-negative cases.

The presence of asthma was assessed at the control visits by similar criteria. Three doctor-diagnosed wheezing episodes were demanded, and at least one of them must have been observed during the preceding 12 months. Asthma was present in 39(48%) and 27(33%) children at the two follow-up visits; among them, 17 (44%, p=0.070) and 16 (59%, p=0.003) belonged to the original rhinovirus group. No association was found between enteroviral infections and later asthma.

Rhinovirus was the most common virus associated with wheezing in early  childhood and carried a significant risk for asthma at school age. In the present study, the risk was 2.4-fold compared to the other than rhinovirus induced wheezing, being partly explained by the different age distributions.

1)      Reijonen T, et al. Pediatrics 2000; 106 (December).