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Published on: December 10, 2013
Rhinovirus Infections and Associated Respiratory Morbidity in Infants: A Prospective Cohort Study
Ines Mack1, Elisabeth Kieninger, Giulia Cangiano
1From the *Pediatric Respiratory Medicine, Inselspital and University of Bern, Bern, Switzerland; †University Children's Hospital (UKBB), University of Basel, Basel, Switzerland; ‡Department of Pediatrics, University of Rome "La Sapienza," Rome, Italy; §Faculty of Medicine, Division of Infectious Diseases and Laboratory of Virology, University Hospitals of Geneva, Geneva, Switzerland; and ¶Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Insights
Rhinovirus (RV) infections are common in infants, often asymptomatic. Environmental factors like season and temperature influence RV prevalence, while host factors such as maternal atopy affect symptom severity.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Virology
- Environmental Epidemiology
Background:
- Rhinovirus (RV) infections are a significant cause of respiratory illness in infants, yet risk factors remain poorly understood.
- Understanding these factors is crucial for developing targeted prevention strategies in healthy infant populations.
Purpose of the Study:
- To investigate the frequency of symptomatic and asymptomatic RV infections in infants.
- To identify host and environmental risk factors associated with RV prevalence and symptom development.
Main Methods:
- Prospective birth cohort study involving 41 infants during their first year of life.
- Weekly telephonic interviews for respiratory health assessment and collection of nasal swabs for RV testing.
- Multilevel logistic regression analysis to determine associations between RV infection, symptoms, and host/environmental factors.
Main Results:
- RVs were detected in 27% of nasal swabs; 51% of RV infections were asymptomatic.
- Risk factors for RV prevalence included autumn months, cooler outdoor temperatures (5-10°C), older siblings, and childcare attendance.
- Respiratory symptoms were less likely in infants <3 months old and those with atopic mothers. Increased tidal volume and colder temperatures (2-5°C) correlated with more severe symptoms.
Conclusions:
- Rhinovirus infections are highly prevalent in infants, with a high rate of asymptomatic cases.
- Environmental factors significantly influence RV infection frequency, while host factors like infant age and maternal history modulate symptom presentation.
- Findings highlight the complex interplay of environmental and host determinants in infant RV infections.
Background:
Risk factors promoting rhinovirus (RV) infections are inadequately described in healthy populations, especially infants.
Objectives:
To determine the frequency of symptomatic and asymptomatic RV infections and identify possible risk factors from host and environment among otherwise healthy infants.
Methods:
In a prospective birth cohort, respiratory health was assessed in 41 term-born infants by weekly telephonic interviews during the first year of life, and weekly nasal swabs were collected to determine RV prevalence. In a multilevel logistic regression model, associations between prevalence and respiratory symptoms during RV infections and host/environmental factors were determined.
Results:
Twenty-seven percent of nasal swabs in 41 infants tested positive for RVs. Risk factors for RV prevalence were autumn months [odds ratio (OR) = 1.71, P = 0.01, 95% confidence interval (CI): 1.13-2.61], outdoor temperatures between 5 and 10°C (OR = 2.33, P = 0.001, 95% CI: 1.41-3.86), older siblings (OR = 2.60, P = 0.001, 95% CI: 1.50-4.51) and childcare attendance (OR = 1.53, P = 0.07, 95% CI: 0.96-2.44). Fifty-one percent of RV-positive samples were asymptomatic. Respiratory symptoms during RV infections were less likely during the first 3 months of life (OR = 0.34, P = 0.003, 95% CI: 0.17-0.69) and in infants with atopic mothers (OR = 0.44, P = 0.008, 95% CI: 0.24-0.80). Increased tidal volume (OR = 1.67, P = 0.03, 95% CI: 1.04-2.68) and outdoor temperatures between 2 and 5°C (OR = 2.79, P = 0.02, 95% CI: 1.17-6.61) were associated with more symptoms.
Conclusions:
RVs are highly prevalent during the first year of life, and most infections are asymptomatic. Frequency of RV infections is associated with environmental factors, while respiratory symptoms during RV infections are linked to host determinants like infant age, maternal atopy or premorbid lung function.
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