Am. J. Respir. Crit. Care Med., Volume 159, Number 3, March 1999, 785-790

Rhinovirus and Respiratory Syncytial Virus in Wheezing Children Requiring Emergency Care
IgE and Eosinophil Analyses

GARY P. RAKES, EURICO ARRUDA, JIM M. INGRAM, GATES E. HOOVER, JUAN C. ZAMBRANO, FREDERICK G. HAYDEN, THOMAS A. E. PLATTS-MILLS, and PETER W. HEYMANN

Departments of Pediatrics, Internal Medicine, and Pathology, University of Virginia Health Sciences Center, Charlottesville, Virginia

This cross-sectional emergency department study of 70 wheezing children and 59 control subjects (2 mo to 16 yr of age) examined the prevalence of respiratory viruses and their relationship to age, atopic status, and eosinophil markers. Nasal washes were cultured for respiratory viruses, assayed for respiratory syncytial virus (RSV) antigen, and tested for coronavirus and rhinovirus RNA using reverse transcription-PCR (RT-PCR). Also evaluated were eosinophil numbers and eosinophil cationic protein (ECP) in both nasal washes and serum, along with total IgE and specific IgE antibody in serum. Respiratory viruses were detected in 82% (18 of 22) of wheezing infants younger than 2 yr of age and in 83% (40 of 48) of older wheezing children. The predominant pathogens were RSV in infants (detected in 68% of wheezing subjects) and rhinovirus in older wheezing children (71%), and both were strongly associated with wheezing (p < 0.005). RSV was largely limited to wheezing children younger than 24 mo of age, but rhinovirus was detected by RT-PCR in 41% of all infants and in 35% of nonwheezing control subjects older than 2 yr of age. After 2 yr of age the strongest odds for wheezing were observed among those who had a positive RT-PCR test for rhinovirus together with a positive serum radioallergosorbent testing (RAST), nasal eosinophilia, or elevated nasal ECP (odds ratios = 17, 21, and 25, respectively). Results from this study demonstrate that a large majority of emergent wheezing illnesses during childhood (2 to 16 yr of age) can be linked to infection with rhinovirus, and that these wheezing attacks are most likely in those who have rhinovirus together with evidence of atopy or eosinophilic airway inflammation.

This article has been cited by other articles:

				B G G Oliver, S Lim, P Wark, V Laza-Stanca, N King, J L Black, J K Burgess, M Roth, and S L Johnston Rhinovirus exposure impairs immune responses to bacterial products in human alveolar macrophages Thorax, June 1, 2008; 63(6): 519 - 525. [Abstract] [Full Text] [PDF]

				J. Jacques, H. Moret, D. Minette, N. Leveque, N. Jovenin, G. Deslee, F. Lebargy, J. Motte, and L. Andreoletti Epidemiological, Molecular, and Clinical Features of Enterovirus Respiratory Infections in French Children between 1999 and 2005 J. Clin. Microbiol., January 1, 2008; 46(1): 206 - 213. [Abstract] [Full Text] [PDF]

				R. S. Peebles Jr. and M. L. Moore A Mechanistic Advance in Understanding RSV Pathogenesis, but Still a Long Way from Therapy Am. J. Respir. Cell Mol. Biol., October 1, 2007; 37(4): 375 - 377. [Full Text] [PDF]

				B. Winther, C. M. Alper, E. M. Mandel, W. J. Doyle, and J. O. Hendley Temporal Relationships Between Colds, Upper Respiratory Viruses Detected by Polymerase Chain Reaction, and Otitis Media in Young Children Followed Through a Typical Cold Season Pediatrics, June 1, 2007; 119(6): 1069 - 1075. [Abstract] [Full Text] [PDF]

				M. R. Edwards, J. Haas, R. A. Panettieri Jr., M. Johnson, and S. L. Johnston Corticosteroids and beta2 Agonists Differentially Regulate Rhinovirus-induced Interleukin-6 via Distinct Cis-acting Elements J. Biol. Chem., May 25, 2007; 282(21): 15366 - 15375. [Abstract] [Full Text] [PDF]

				C. F. Robertson, D. Price, R. Henry, C. Mellis, N. Glasgow, D. Fitzgerald, A. J. Lee, J. Turner, and M. Sant Short-Course Montelukast for Intermittent Asthma in Children: A Randomized Controlled Trial Am. J. Respir. Crit. Care Med., February 15, 2007; 175(4): 323 - 329. [Abstract] [Full Text] [PDF]

				D. Proud and C.-W. Chow Role of Viral Infections in Asthma and Chronic Obstructive Pulmonary Disease Am. J. Respir. Cell Mol. Biol., November 1, 2006; 35(5): 513 - 518. [Abstract] [Full Text] [PDF]

				P A B Wark and P G Gibson Asthma exacerbations {middle dot} 3: Pathogenesis. Thorax, October 1, 2006; 61(10): 909 - 915. [Abstract] [Full Text] [PDF]

				D. R. Gold and A. L. Fuhlbrigge Inhaled corticosteroids for young children with wheezing. N. Engl. J. Med., May 11, 2006; 354(19): 2058 - 2060. [Full Text] [PDF]

				S. Carraro, J. Doherty, K. Zaman, I. Gainov, R. Turner, J. Vaughan, J. F. Hunt, J. Marquez, and B. Gaston S-nitrosothiols regulate cell-surface pH buffering by airway epithelial cells during the human immune response to rhinovirus Am J Physiol Lung Cell Mol Physiol, May 1, 2006; 290(5): L827 - L832. [Abstract] [Full Text] [PDF]

				C S Murray, G Poletti, T Kebadze, J Morris, A Woodcock, S L Johnston, and A Custovic Study of modifiable risk factors for asthma exacerbations: virus infection and allergen exposure increase the risk of asthma hospital admissions in children Thorax, May 1, 2006; 61(5): 376 - 382. [Abstract] [Full Text] [PDF]

				S. L. Johnston Impact of viruses on airway diseases Eur. Respir. Rev., December 1, 2005; 14(95): 57 - 61. [Abstract] [Full Text] [PDF]

				D. C. Pevear, F. G. Hayden, T. M. Demenczuk, L. R. Barone, M. A. McKinlay, and M. S. Collett Relationship of Pleconaril Susceptibility and Clinical Outcomes in Treatment of Common Colds Caused by Rhinoviruses Antimicrob. Agents Chemother., November 1, 2005; 49(11): 4492 - 4499. [Abstract] [Full Text] [PDF]

				R. A. Silverman, K. Ito, L. Stevenson, and H. M. Hastings The Relationship of Fall School Opening and Emergency Department Asthma Visits in a Large Metropolitan Area Arch Pediatr Adolesc Med, September 1, 2005; 159(9): 818 - 823. [Abstract] [Full Text] [PDF]

				S. L. Johnston Overview of Virus-induced Airway Disease Proceedings of the ATS, August 1, 2005; 2(2): 150 - 156. [Abstract] [Full Text] [PDF]

				R. B. Turner, R. Bauer, K. Woelkart, T. C. Hulsey, and J. D. Gangemi An Evaluation of Echinacea angustifolia in Experimental Rhinovirus Infections N. Engl. J. Med., July 28, 2005; 353(4): 341 - 348. [Abstract] [Full Text] [PDF]

				P. Gruteke, A. S. Glas, M. Dierdorp, W. B. Vreede, J.-W. Pilon, and S. M. Bruisten Practical Implementation of a Multiplex PCR for Acute Respiratory Tract Infections in Children J. Clin. Microbiol., December 1, 2004; 42(12): 5596 - 5603. [Abstract] [Full Text] [PDF]

				R. B. Turner, K. A. Biedermann, J. M. Morgan, B. Keswick, K. D. Ertel, and M. F. Barker Efficacy of Organic Acids in Hand Cleansers for Prevention of Rhinovirus Infections Antimicrob. Agents Chemother., July 1, 2004; 48(7): 2595 - 2598. [Abstract] [Full Text] [PDF]

				C. S. Murray, A. Simpson, and A. Custovic Allergens, Viruses, and Asthma Exacerbations Proceedings of the ATS, April 1, 2004; 1(2): 99 - 104. [Abstract] [Full Text] [PDF]

				S. D. Message and S. L. Johnston Host defense function of the airway epithelium in health and disease: clinical background J. Leukoc. Biol., January 1, 2004; 75(1): 5 - 17. [Abstract] [Full Text] [PDF]

				G. D. Brooks, K. A. Buchta, C. A. Swenson, J. E. Gern, and W. W. Busse Rhinovirus-induced Interferon-{gamma} and Airway Responsiveness in Asthma Am. J. Respir. Crit. Care Med., November 1, 2003; 168(9): 1091 - 1094. [Abstract] [Full Text] [PDF]

				G. Rachelefsky Treating Exacerbations of Asthma in Children: The Role of Systemic Corticosteroids Pediatrics, August 1, 2003; 112(2): 382 - 397. [Abstract] [Full Text] [PDF]

				A Oommen, R Patel, M Browning, and J Grigg Systemic neutrophil activation in acute preschool viral wheeze Arch. Dis. Child., June 1, 2003; 88(6): 529 - 531. [Abstract] [Full Text] [PDF]

				R. F. Lemanske Jr. Is Asthma an Infectious Disease?: Thomas A. Neff Lecture Chest, March 1, 2003; 123(2007): 385S - 390S. [Abstract] [Full Text] [PDF]

				A. M. Fendrick, A. S. Monto, B. Nightengale, and M. Sarnes The Economic Burden of Non-Influenza-Related Viral Respiratory Tract Infection in the United States Arch Intern Med, February 24, 2003; 163(4): 487 - 494. [Abstract] [Full Text] [PDF]

				A. Oommen and J. Grigg Urinary leukotriene E4 in preschool children with acute clinical viral wheeze Eur. Respir. J., January 1, 2003; 21(1): 149 - 154. [Abstract] [Full Text] [PDF]

				K Hashimoto, R S Peebles Jr, J R Sheller, K Jarzecka, J Furlong, D B Mitchell, T V Hartert, and B S Graham Suppression of airway hyperresponsiveness induced by ovalbumin sensitisation and RSV infection with Y-27632, a Rho kinase inhibitor Thorax, June 1, 2002; 57(6): 524 - 527. [Abstract] [Full Text] [PDF]

				S. D Message and S. L Johnston Viruses in asthma: The role of viruses in childhood respiratory infections Br. Med. Bull., March 1, 2002; 61(1): 29 - 43. [Abstract] [Full Text] [PDF]

				J. E. GERN, R. VRTIS, K. A. GRINDLE, C. SWENSON, and W. W. BUSSE Relationship of Upper and Lower Airway Cytokines to Outcome of Experimental Rhinovirus Infection Am. J. Respir. Crit. Care Med., December 1, 2000; 162(6): 2226 - 2231. [Abstract] [Full Text]

				T. M. Reijonen, A. Kotaniemi-Syrjänen, K. Korhonen, and M. Korppi Predictors of Asthma Three Years After Hospital Admission for Wheezing in Infancy Pediatrics, December 1, 2000; 106(6): 1406 - 1412. [Abstract] [Full Text]

				D. J. Adamko, B. L. Yost, G. J. Gleich, A. D. Fryer, and D. B. Jacoby Ovalbumin Sensitization Changes the Inflammatory Response to Subsequent Parainfluenza Infection: Eosinophils Mediate Airway Hyperresponsiveness, M2 Muscarinic Receptor Dysfunction, and Antiviral Effects J. Exp. Med., November 15, 1999; 190(10): 1465 - 1478. [Abstract] [Full Text] [PDF]