Background: Viral-induced wheezing episodes are common in early childhood. Wheezing episodes with Rhinovirus (RV) were shown to be associated with asthma in predisposed children. The aim of this study was to document the viral etiology of acute wheezing episodes in young children with or without predisposition to asthma.
Methods: Children 6 to 36 months of age with episode of a viral illness and wheezing were prospectively enrolled. Nasopharyngeal aspirates were tested using a multiplex reverse transcription-PCR assay for the detection of 11 viral pathogens. Asthma predisposition was calculated using a modified Asthma Predictive Index (API).
Results: 116 children (mean age 15.5 months) were enrolled. 103(89%) were included in data analysis. RV was detected in 39 (38%) samples, RSV in 44 (43%), Bocavirus in 13 (13%), Parainfluenza in 4 (4%), HMPV in 4 (4%), Coronaviruses in 3 (3%), and 6 (6%) were negative. Co-infection with two or more pathogens was detected in 12 (12%) of the samples. No significant differences were found in clinical presentation between pathogens. Corticosteroids were more commonly used in children with RV infection. 57 (56%) of children had a positive API. There was a statistically insignificant
trend towards higher rate of RV infection in children with a positive API (41% vs. 34%, p=0.308).
Conclusions: RV infection is a major cause of wheezing in young healthy children and account for almost 40% of the patients seen in the ED for acute episode. Further research should determine the role of RV infection in predicting asthma.
