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Illness and otological changes during upper respiratory virus infection
W J Doyle1, C M Alper, C A Buchman
1Department of Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
The Laryngoscope
|July 13, 2000
Summary
Many upper respiratory virus infections lead to complications, but studies may underestimate their frequency. This research reveals that even individuals without reported illness can develop complications, highlighting a significant presentation bias.
Area of Science:
- Virology
- Epidemiology
- Otolaryngology
Background:
- Upper respiratory virus infections can lead to complications in adjacent anatomical areas.
- Epidemiological studies often calculate complication frequency based on symptomatic individuals, potentially skewing results.
- Infected individuals who do not exhibit symptoms may still develop complications.
Purpose of the Study:
- To quantify the presentation bias in estimating complication frequency during controlled viral upper respiratory infections.
- To assess the relationship between illness and otological complications in experimentally induced infections.
Main Methods:
- A prospective, experimental study involving 316 adult volunteers.
- Volunteers were experimentally infected with rhinovirus (types 39 and hanks) or influenza A virus.
- Data on illness, abnormal middle ear pressure, and middle ear pressure without illness were analyzed.
Main Results:
- Approximately 50% of infected subjects reported illness across all three viruses.
- While symptomatic individuals had a higher rate of abnormal middle ear pressure, about one-third of those with this complication did not report illness.
- This indicates that a substantial portion of complications occur in asymptomatic or minimally symptomatic individuals.
Conclusions:
- Epidemiological surveys likely underestimate the true incidence of complications from viral upper respiratory infections due to presentation bias.
- A significant number of complications arise in individuals not classified as ill.
- Further research should account for asymptomatic cases to accurately determine complication rates.