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Published ahead of print on October 29, 2004, doi:10.1164/rccm.200406-730OC

Am. J. Respir. Crit. Care Med., Volume 171, Number 2, January 2005, 137-141

A more recent version of this article appeared on January 15, 2005
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Submitted on June 9, 2004
Accepted on October 25, 2004

Severe Respiratory Syncytial Virus Bronchiolitis in Infancy and Asthma and Allergy at Age 13

Nele Sigurs1*, Per M Gustafsson2, Ragnar Bjarnason3, Fredrik Lundberg1, Susanne Schmidt1, Fridrik Sigurbergsson4, and Bengt Kjellman5

1 Department of Pediatrics, Boras Central Hospital, Boras, Sweden, 2 Queen Silvia Children's Hospital, Goteborg, Sweden, 3 Department of Pediatrics, Landspitali University Hospital, Reykjavik, Iceland, 4 Emergency Department, Landspitali University Hospital, Reykjavik, Iceland, 5 Department of Pediatrics, Skovde Central Hospital, Skovde, Sweden

* To whom correspondence should be addressed. E-mail: nele.sigurs{at}telia.com.

We have prospectively studied wheezing disorder and allergy in 47 children hospitalized with RSV bronchiolitis in infancy and 93 matched controls. Subjects with at least three episodes of wheezing were defined as recurrent wheezers and as asthmatics if the episodes were doctor verified. Here we report the outcome at age 13 in 46/47 RSV children and 92/93 controls. Wheezing disorder and clinical allergy were estimated using a questionnaire. Skin prick tests were performed and serum IgE antibodies measured. Spirometry was undertaken at rest, after dry air challenge and after beta2-agonist inhalation. The occurrence of symptoms over the previous 12 months was significantly higher in the RSV group than among the controls, 43% vs 8% for asthma/recurrent wheezing and 39% vs 15% for allergic rhinoconjunctivitis. Sensitization to common inhaled allergens was more frequent in the RSV group than in the controls, judged by skin prick tests (50% vs 28%; p=0.022), or by serum IgE antibodies (45% vs 26%; p=0.038). Compared to the controls, the RSV group showed mild airway obstruction both at rest and after bronchodilation, and had slightly more reactive airways. RSV bronchiolitis in infancy severe enough to cause hospitalization is a risk factor for allergic asthma in early adolescence.
Key words: Airway obstruction, atopic hypersensitivity, children, respiratory syncytial virus




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