A prospective study of respiratory infection in adult asthmatics and their normal spouses

Abstract

Summary A prospective study of respiratory infections was performed in nineteen married asthmatics and their normal spouses who were examined at monthly intervals during a 1‐year period. The colds described were associated with nasal symptoms, sore throat and usually malaise, fever, cough and hoarseness. The asthmatics reported a larger number of these symptomatic episodes that the non‐asthmatics but significantly fewer of the episodes in the asthmatics were objectively confirmed by viral isolation or rise in serum titre of viral antibody. The frequency of respiratory infections was not influenced by the long term use of inhaled beclomethasone dipropionate and oral corticosteroid drugs. Less than 10% of the exacerbations of asthma were associated with respiratory infection. The disability resulting from respiratory infections in the asthmatics did not significantly exceed that in the non‐asthmatics.

A Case‐Control Study of the Role of Cold Symptoms and other Historical Triggering Factors in Asthma Exacerbations

“…It has been suggested (10,11) that the difference between reports of colds in children and adults with asthma might relate to differences in viral strains with patient's age. There are particular difficulties in the detection of rhinoviruses and coronaviruses using standard serological and culture methods.…”

“…Symptomatic colds were more common among adults with asthma than their nonasthmatic spouses (10), particularly in the spring, summer and fall. A recent study of severe exacerbations of asthma in 33 patients presenting to an emergency room (11) also failed to detect objective evidence of viral infections using culture, serology and rapid antigen detection by an immunofluorescent technique used on nasal swabs.…”

“…In our previous study of adults with asthma (10), only 3% of exacerbations were associated with confirmed viral infections and 9% with symptomatic colds. Symptomatic colds were more common among adults with asthma than their nonasthmatic spouses (10), particularly in the spring, summer and fall.…”

“…In adults, they have been shown to increase airway responsiveness, even in subjects without clinical asthma (5), especially in allergic subjects (6); in mice, viral infections can enhance airway sensitization to allergen (7). Some, but not all studies have shown an association with acute asthma exacerbations (8)(9)(10)(11), especially when newer, sensitive virological detection methods are used (8). Beasley et al (9) identified a viral respiratory tract infection in 10% of 178 exacerbations of asthma in 31 adults, but found a higher proportion (36%) of severe exacerbations to have such an association.…”

Impact of respiratory virus infection in patients with chronic chest disease

“…Respiratory virus infections are frequently associated with exacerbations of chronic bronchitis [1][2][3][4] or asthma [5][6][7][8][9][10], and patients with chronic chest disease appear to have an increased susceptibility to respiratory tract infections when compared to their spouses [ 11 ] or siblings [ 1 2]. Annual influenza vaccine is recommended for high-risk patients, including those with respiratory disease [ 13]; however, vaccines are not currently available against other respiratory viruses.…”