Cockroach and other inhalant allergies in infantile asthma

Infantile asthma is commonly thought to be caused by viral respiratory infections and exposure to second-hand cigarette smoke. Allergy has not been felt to be a major cause of infantile asthma and infants and small children are not commonly skin tested.

To determine the frequency of skin test reactivity in asthmatic children less than 3 years of age.

We evaluated 196 (50 female/146 male) children with infantile asthma for allergy. Infantile asthma was defined as three or more episodes of wheezing in a child less than 3 years of age. A careful environmental history was obtained on all children. All were skin tested to alternaria, cat, dog, cockroach, and house dust mites (HDM) extracts using the prick technique with the Greer Dermapik.

Forty-five percent of the infants and children tested had at least one positive skin test. 51/196 (26%) of the children were skin test positive to cockroach, 17.3% to HDM, 13.8% to cat, 6.6% to alternaria, and 6.1% positive to dog. For the 49 children who were less than 1 year of age, 28.5% were positive to cockroach, 10.2% to HDM, 10.2% to cats, 4% to alternaria, and 0% to dog.

Allergy to cockroach and other indoor allergens may be a significant contributor to infantile asthma in a rural setting. Skin testing children with infantile asthma may provide useful information for institution of environmental controls measures in the child's home.