Date of Award

6-3-2009

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Jeffrey Kahn

Abstract

Human rhinoviruses (HRV) are a common cause of the common cold, and are thought to be associated with asthma exacerbations in both children and adults. Recently, HRV have been identified as a major cause of hospitalization in children < 5 years old. The purpose of this study was too determine whether HRV are a cause of either wheezing and/or hospitalization in children < 2 years old. We used a PCR assay to screen for HRV infection in children < 2 years old: 1) with symptoms of upper or lower respiratory tract disease without wheezing; 2) with wheezing; 3) who were asymptomatic. A group of children who had a respiratory specimen submitted to a diagnostic laboratory for whatever reason and who tested negative for four common viruses in the clinical lab were also screened. All specimens were collected between January 1 and December 31, 2004. Phylogenetic analyses were performed on a majority of HRV isolates. Overall, 28 (17%) of 165 children with symptoms of respiratory traction infection without wheezing; 21 (26.3%) of 80 children with symptoms of respiratory tract infection and wheezing; 3 (3%) of 93 asymptomatic children and 47 (23.3%) of 202 children with specimens submitted to the diagnostic laboratory tested positive for HRV. The difference between the rate of infection in the asymptomatic group and each of the three other groups was statistically significant (p<0.01). Among children with samples submitted to the diagnostic laboratory in whom HRV was the only identified pathogen, 55% were hospitalized. This rate was similar to that observed for respiratory syncytial virus (52.7%) among children of a similar age group and time period (P=0.85). Diverse groups of HRV were circulating during the one-year study period. We conclude that HRV are important pathogens among young children < 2 years old and are responsible for a significant proportion of wheezing this age group. Among a group of children with a respiratory specimen submitted to the diagnostic laboratory in whom a rhinovirus was the only identified pathogen, a majority were hospitalized.

Comments

This is an Open Access Thesis.

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