Article Text

RESPIRATORY MORBIDITY FOLLOWING RESPIRATORY SYNCYTIAL VIRUS BRONCHIOLITIS: A 5-YEAR FOLLOW-UP
  1. L D McFetridge1,
  2. B McCord1
  1. 1Department of Paediatrics, Altnagelvin Hospital, Londonderry, Co Londonderry, N Ireland, UK

Abstract

Background Respiratory syncytial virus (RSV) infects 50% of children in the first year of life and is the commonest cause of lower respiratory tract infection and subsequent hospitalisation in this population. Current evidence suggests that RSV infection predisposes infants to both recurrent wheeze and asthma.

Objective To establish the incidence of respiratory morbidity, in particular post-bronchiolitic wheeze and asthma, 5 years after RSV bronchiolitis in the first year of life.

Methods Infants <1 year hospitalized with confirmed RSV bronchiolitis over a 1-year period were identified and charts reviewed. Postal questionnaires were sent to the parents/guardians to determine the incidence of both previous and current respiratory disease.

Results Of the 133 patients identified, 63 responded to the postal questionnaires and were included in the study. 62% (39) patients reported post-bronchiolitic wheeze and in 43% this was ongoing at the time of follow-up. 32% (20) patients had a diagnosis of asthma, evidenced in most by the current use of inhalers. In 43% of patients with post-bronchiolitic wheeze and 55% with asthma there was documented parental smoking. In patients with no wheeze or asthma there was significantly less exposure to cigarette smoke.

Conclusion RSV bronchiolitis is associated with considerable ongoing respiratory disease up to 5 years following infection. However, exposure to cigarette smoke is an important additional contributing factor that should be appreciated by medical staff and highlighted to parents.

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