Elsevier

The Journal of Pediatrics

Volume 157, Issue 3, September 2010, Pages 505-506
The Journal of Pediatrics

Clinical and Laboratory Observation
Underestimation of Influenza Viral Infection in Childhood Asthma Exacerbations

https://doi.org/10.1016/j.jpeds.2010.04.067Get rights and content

Bocavirus was found in 11.6% of hospitalized children and 13% of ambulatory patients with exacerbations of asthma, and respiratory syncytial virus was found in 13.5% and 17.7%, respectively. In addition, influenza A virus was detected in 2.6% of hospitalized children and 14.1% (P < .001) of ambulatory-treated patients. Thus, the influenza burden in asthma may be underestimated.

Section snippets

Methods

This prospective study included children of 1.5 to 15.0 years of age examined for acute asthma in the emergency department of a Paris hospital from November through March during 4 successive winters (2005 to 2009) with the same design as previously reported studies.6, 7 All children with symptoms considered to be severe (marked expiratory wheezing despite 3 inhalations of β2-adrenergic aerosols in 1 hour or transcutaneous oxygen saturation <95% for >3 hours) were hospitalized. Other children

Results

During the winter months (Nov 1-Mar 31) from 2005 to 2009, 369 children >18 months of age previously diagnosed as having asthma were referred to the emergency department of our hospital for acute wheezing. Nasopharyngeal aspirates or a precise clinical history were absent in 30 patients, so only 339 patients were included in the study (55% males), 232 hospitalized (mean age, 44.7 months; range, 21-107 months) and 107 discharged home (mean age, 38 months; range, 18-84 months). None of these

Discussion

One-third of children with asthma require immediate therapy for acute complications per year, and >50% of the annual costs for childhood asthma relate to hospitalizations or emergency care. Viral infections are more often associated with asthma exacerbations in young children than in adults, but the respective roles of the different respiratory viruses in acute exacerbations remain disputed. The relative importance of influenza vaccination in children with asthma has been debated. Most

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The authors declare no conflicts of interest.

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