Viral URI
Viral Upper Respiratory Tract Infections
This study by Tansee et.al (2008) discusses Viral upper respiratory tract infections (URI) and the comorbid condition of Otitis media among children. There is a very high incidence of Otitis media among pediatric subjects. Acute Otitis media (AOM) caused by viral URI, is a severe middle ear infection that can even result in deafness. This study is particularly significant, as not much research has focused on the association between specific virus types in URI and the onset of Otitis media complication. The University of Texas Medical Branch conducted this study. For the study, a total of 294 children between 6 months and 3 years of age were followed up over a period of 1-year. The subjects were carefully screened to exclude children with chronic medical conditions and with a previous history of ear infections. During the period of study, parents were asked to notify the study physician immediately upon the onset of cold or any URI symptoms. The children were followed up for a few days to assess for any Otitis media complications. The study physicians also followed up with couple of home visits during the 2nd and 3rd week following an URI for tympanometry. Virological studies were performed on the respiratory specimens gathered during the initial visit for URI and post detection of AOM. During the study period, a total of 1295 URI episodes were documented and of these 414 (32%) lead to the onset of AOM. 26 separate cases of AOM not associated with URI were also reported in the study accounting for a total of 440 episodes of AOM.
Virological tests indicated that in all (64.6%) or 558 of 864 URI specimens were positive for viruses. Results from the tests showed that Adenovirus and rhinovirus were the most common viruses associated with URI. However, the results further revealed that coronavirus, RSV and adenovirus were the three most commonly associated virus types in URI complicating AOM. This result is in concurrence with previous studies by Henderson et al., Heikkinen et.al etc. Adenovirus was responsible for almost 23.6% of AOM, while RSV was implicated in 15.8% of the cases of Otitis media. The high rates of these two viruses and their association with AOM incidence offers new implications for treatment of URI in children. The Overall results from this study indicate that over 61% of the URI is OM complicating with 37% AOM and 24% OME respectively. OM complication was manifest in 50% of children with URI by adenovirus, coronovirus and respiratory syncytial virus. Other viruses such as influenza, parainfluenza, rhinovirus and enterovirus were also associated with the onset of OM as evidenced by the fact that almost a third of the subjects infected by these viruses had OM complication. The inference is that the overall incidence of OM among children can be largely contained if viral URI is controlled among children. In particular, targeted therapeutic interventions that focus on preventing URI infections with adenovirus, RSV and coronovirus should significantly reduce the OM infections among the pediatric population.
Bibliography
1) Tasnee Chonmaitree, M.D., Krystal Revai & James J. Grady et.al (2008), ‘Viral Upper respiratory tract infection and Otitis Media complication in Young Children’ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744371/
