Authors:
Kusel MM; Kebadze T; Johnston SL; Holt PG; Sly PD
Authors notes:
Eur Respir J. 2012 Apr;39(4):876-882
Keywords:
Asthma, Viral Respiratory Infections, Atopy
Abstract
Severe viral respiratory illnesses and atopy are risk factors for childhood wheezing and asthma.
The aim of this study was to explore associations between severe respiratory infections and atopy in early childhood with wheeze and asthma persisting into later childhood.
At 10 yrs, 60% of the cohort was atopic, 25.9% had current eczema, 18.4% current asthma and 20.4% persistent wheeze.
35.8% experienced at least one lower respiratory infection (LRI) associated with fever and/or wheeze in first year of life.
Children who had wheezy or, in particular, febrile LRI in infancy and were atopic by 2 yrs, were significantly more likely to have persistent wheeze (RR 3.51, 95% CI 1.83-6.70; p<0.001) and current asthma (RR 4.92, 95% CI 2.59-9.36; p<0.001) at 10 yrs.
Severe viral respiratory infections in infancy and early atopy are risk factors for persistent wheeze and asthma.
The strongest marker of the asthmatogenic potential of early life infections was concurrent fever.
The occurrence of fever during respiratory illnesses is an important marker of risk for wheeze and asthma later in childhood, suggesting it should be measured in prospective studies of asthma aetiology.