The future for lung disease in children

The textbook space dedicated to specific diseases usually reflects the importance of the disease at the time of publication. In Sir Wilfred Sheldon’s “Diseases of Infancy and Childhood” published in 1951, the top five respiratory disorders were tuberculosis (36), suppurative lung disease (22), pneumonia (20), croup, diphtheria and bronchitis (12) and asthma (10), where the figures in parentheses reflect the relative percentage page space of the five disorders. In 1990 in “Respiratory Illness in Children” by Phelan, Landau and Olinsky the top five were acute respiratory infection (30), asthma (27), cystic fibrosis (19), congenital abnormalities (16) and tuberculosis (8). By the time textbooks are published they are already out of date because of the rapidly changing clinical picture, but what is clear over the past half century is that paediatric respiratory disease has remained common and is a significant burden in childhood for families and for the health economy. In the UK, approximately 25% of all paediatric outpatient attendances, 30% of paediatric inpatient events and 35% of paediatric primary care consultations are because of significant respiratory morbidity. Much adult respiratory disease has its origins in childhood (or even at conception in diseases with strong genetic influences). Sixty percent of asthma in adults today originates in …