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Bronchiolitis: age and previous wheezing episodes are linked to viral etiology and atopic characteristics

Tuomas Jartti1, Pasi Lehtinen, Tytti Vuorinen

  • 1Departments of Pediatrics, Turku University Hospital, Turku, Finland. tuomas.jartti@utu.fi

The Pediatric Infectious Disease Journal
|March 5, 2009
PubMed

Insights

Bronchiolitis definitions impact risk factor identification for recurrent wheezing and asthma. The study suggests refining the clinical definition to include only first-time wheezing episodes for better accuracy.

Area of Science:

  • Pediatric respiratory medicine
  • Epidemiology of childhood respiratory diseases
  • Allergy and immunology in pediatrics

Background:

  • Diagnostic criteria for bronchiolitis lack standardization.
  • Variability in definitions may affect understanding of disease progression and risk factors.

Purpose of the Study:

  • To investigate how risk factors for recurrent wheezing and asthma differ based on various bronchiolitis definitions.
  • To analyze the influence of viral etiology and atopic characteristics on these risk factors.

Main Methods:

  • Studied 259 hospitalized wheezing children (0-36 months) for viral etiology and atopic characteristics.
  • Utilized conventional and molecular methods to detect 16 viruses.
  • Assessed atopic markers including eczema, IgE levels, eosinophils, and modified asthma predictive index.

Main Results:

  • Respiratory viruses detected in 93% of cases; allergic sensitization in 26%.
  • Rhinovirus infections and atopic factors were more prevalent in children with recurrent wheezing, particularly those under 24 and 36 months.
  • Significant associations found between age, recurrent wheezing, and atopic/virologic risk factors for asthma.

Conclusions:

  • Age and prior wheezing episodes are key clinical factors linking atopy and rhinovirus to asthma risk.
  • Current US/UK guidelines define bronchiolitis up to 24 months.
  • The study proposes a revised definition of bronchiolitis to include only first wheezing episodes.
Abstract

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