Virological Findings and Blood Gas Tensions in Acute Lower Respiratory Tract Infections in Children

Simpson, Hamish; Matthew, D J; Inglis, J.M.; George, Ezmin

doi:10.1136/bmj.2.5920.629

Cited by 17 publications

(8 citation statements)

References 28 publications

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“…Again rhinovirus identification was the most variable between studies and the study with the lowest overall rate [17] (14 3%) had a low rate of rhinoviruses identified although rhinoviruses were the predominant organisms. From the description given of the virology [48] it does not appear that this low rate was due to inadequate methods, but again a slightly higher rate (17%) was reported from specimens taken within 48 hr of symptom onset. Two studies with high overall isolation rate [23,24] did not attempt to identify rhinoviruses at all.…”

Section: Virus Identification Rates In Exacerbations Of Asthma and Whmentioning

confidence: 95%

Viruses as precipitants of asthma symptoms. I. Epidemiology

Pattemore

Johnston

Bardin

1992

Clin Experimental Allergy

301

187

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The epidemiological studies cited have indicated that viruses are commonly associated with wheezing illnesses in populations, in individuals, and in time, but, unlike bacteria, are rarely found during asymptomatic periods. Viruses have been identified in up to 50% of wheezing illnesses and asthma exacerbations occurring in childhood, and in up to 20% of those in adults. In childhood the predominant organisms identified have been rhinoviruses. RSV and parainfluenza viruses, but coronaviruses have not been studied adequately. Wheezing appears to be more common during rhinovirus and RSV than other virus infections in children spontaneously presenting with respiratory infections to medical care, but all virus groups have been incriminated, and in general, wheezing occurs in upwards of 50% of viral infections in asthmatics followed prospectively. The few adult studies available show little difference between viruses in identification rates during wheezing, or propensity to result in wheezing. The predominant viruses change with age, and children with asthma seem to be more prone to symptomatic virus infections than other children, although the presence of atopy alone does not appear to be important. There are important gaps in our knowledge of the epidemiology of virus-associated wheezing attacks, and further prospective studies are required, using early investigation and sensitive methods for identifying rhinoviruses and coronaviruses, to study severe asthma in children and adults. It is hoped that the use of nucleic acid hybridization and newer antigen-detection techniques will improve the ability to identify difficult viruses such as coronaviruses and rhinoviruses in the future. The ability to identify subclinical infections and compare the ratio of subclinical to clinical infections in normal and asthmatic children would be useful but would require intense monitoring of both groups for an extended period (minimum 12 months to cover seasonal variation) with full virological studies every 2-4 weeks-a difficult and expensive task. Another important line of study would be to prospectively document indoor aeroallergen exposure and virus infections in the same individuals, and compare their importance as precipitants of acute severe asthma attacks. With a clearer understanding of the groups at risk for asthma attacks, and the factors which put them at risk and precipitate their attacks, effective preventive strategies will become more feasible.

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Section: Virus Identification Rates In Exacerbations Of Asthma and Whmentioning

confidence: 95%

Viruses as precipitants of asthma symptoms. I. Epidemiology

Pattemore

Johnston

Bardin

1992

Clin Experimental Allergy

301

187

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“…Arterial carbon dioxide levels may be above 10 kPa in infants admitted to hospital.' 7 Respiratory syncytial virus and the other respiratory viruses can be identified by fluorescent antibody techniques or by culture of nasopharyngeal secretions. Although rapid viral identification has been used to isolate children positive for RSV,21 the lack of a positive result does not preclude a diagnosis of bronchiolitis or affect outcome.…”

Section: Investigationsmentioning

confidence: 99%

Management of acute bronchiolitis.

Rakshi¹,

Couriel²

1994

Archives of Disease in Childhood

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“…On two occasions cell cultures were not available; the specimens were then stored at -700C until cultures were available. The subsequent culture techniques have been described (Simpson et al, 1974). Table 2 shows that there were 127 episodes of wheezing and virus culture was attempted in 91 (72%).…”

Section: Methodsmentioning

confidence: 99%

Viral infection as a precipitant of wheeze in children. Combined home and hospital study.

Mitchell¹,

Inglis²,

Simpson³

1978

Archives of Disease in Childhood

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SUMMARY Sixteen children with asthma were studied for one year and viral isolation attempted during all episodes of wheezing. In 91 episodes investigated, 13 viruses were isolated (isolation rate 14%), whereas only one virus was isolated from 120 specimens taken when the children were symptom free. Rhinovirus was the commonest isolate and most were obtained during August, September, and October. Episodes of wheezing associated with virus infection were not clinically different nor more severe than those due to other precipitants.Upper respiratory tract infection is one of the apparent precipitants of wheezing attacks in children. A relationship between viral infection of the upper respiratory tract and wheeziness has been shown in several studies-hospital inpatients (McIntosh et al., 1973), hospital outpatients (Minor et al., 1974a(Minor et al., , 1976, and general practice (Horn et al., 1975). Some have been confined to the winter months and case selection has been biased by the exclusion of children whose wheezing attacks were thought not to be precipitated by infection (Berkovich et al., 1970;McIntosh et al., 1973;Minor et al., 1974aMinor et al., , 1976. We recently reported a 3-year hospital based study (Mitchell et al., 1976) free from these constraints of timing and case selection and confirmed the association of viral infection and wheeziness. The selection of appropriate controls presents difficulties and to overcome this viral culture has been attempted in index patients during wheeze-free periods (McIntosh et al., 1973;Minor et al., 1976).This study was undertaken to determine the incidence, nature, and seasonal variation of viral infection in children with recurrent wheeziness. The children were chosen consecutively, whatever the suspected precipitant of wheeze, and were studied for one year. Viral culture was attempted during all exacerbations of wheeze, whether or not viral infection was suspected on clinical grounds or admission to hospital occurred. The clinical features of wheezy episodes were noted. By attempting viral culture during symptom-free periods control data were obtained.

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Virological Findings and Blood Gas Tensions in Acute Lower Respiratory Tract Infections in Children

Cited by 17 publications

References 28 publications

Viruses as precipitants of asthma symptoms. I. Epidemiology

Viruses as precipitants of asthma symptoms. I. Epidemiology

Management of acute bronchiolitis.

Viral infection as a precipitant of wheeze in children. Combined home and hospital study.

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