Viral Respiratory Infections and the Development of Atopy and Asthma

Background: There is an association between  severe  RSV bronchiolitis in early childhood, recurrent wheezing, asthma, and allergy in later childhood.  And also becomes  increasingly evident that other viruses such as RV,  also showed  association with the development of asthma. The objective of this study is to know the relationship between viral respiratory infections in the first five years of age and the development of atopy and asthma.

Methods: This study  is a prospective follow-up study in two communities, 9 years after a respiratory infection study was performed. Assessment included questionnaires,  physical examination, skin prick tests (SPT), pulmonary function test (PFT), and reversibility testing. 

Results: Three hundred thirty-two children, age 7 to 14 years, including  182 (54.8%) boys, were enrolled in the study.  In 86 children, histories of viral respiratory infections (RSV, RV, and hMPV) were detected. The rate of positive SPT  was high (81.6%), and   15 (4,5%) children showed dermatographism.  The percentage of positive SPT among children with and without viral respiratory infections  was almost  similar (83.4% vs 85.4%). The positive SPT > 1 in children with history of viral respiratory infections was 65.9% ; 5.9% with 1 positive, 27.1% with 2 – 3 positive, 20% with 4 – 5 positive and 18.8% with > 5 positive; while the positive SPT > 1 in the non viral respiratory infections was 75,3%; 9.3%, 23.9%, 30.4%, and 21.1%, respectively. The difference between those two groups of children was not significant ( p=0.076).  History of asthma in the children with history of  respiratory infections was higher compared with the non infections group (19.7% vs 8.1%).  However, the spirometry results show no difference (p> 0.05) of FEV1 < 80%, FVC < 80%, FEV1/FVC < 80% and bronchodilator response > 12%, between those 2 groups.

Conclusions: The positive rate of SPT in the children is high, but no difference  is found between history of  viral respiratory infections in early life  in relation to the later development of atopy and asthma. The spirometry test results show no difference between the two groups.