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Early rattles, purrs and whistles as predictors of later wheeze
  1. S W Turner1,
  2. L C A Craig2,
  3. P J Harbour1,
  4. S H Forbes1,
  5. G McNeill2,
  6. A Seaton2,
  7. G Devereux2,
  8. G Russell1,
  9. P J Helms1
  1. 1
    Department of Child Health, University of Aberdeen, Aberdeen, Scotland, UK
  2. 2
    Environmental and Occupational Medicine, University of Aberdeen, Aberdeen, Scotland, UK
  1. Dr S W Turner, Department of Child Health, University of Aberdeen, Royal Aberdeen Children’s Hospital, Foresterhill, Aberdeen AB25 2ZG, Scotland, UK; s.w.turner{at}


Background: Asthma is a common condition characterised by wheeze. Many different respiratory sounds are interpreted by parents as “wheeze” in young children.

Aim: To relate different respiratory sounds reported as wheeze in 2-year-olds to asthma outcomes at age 5 years.

Methods: As part of a longitudinal cohort study, parents completed respiratory questionnaires for their children at 2 and 5 years of age. Parents who reported wheeze were given options to describe the sound as rattling, purring or whistling.

Results: Of the 1371 2-year-olds surveyed, 210 had current wheeze, of whom 124 had rattle, 49 purr and 24 whistle. Children with whistle at 2 years were more likely to have mothers with asthma, and children with rattle and purr were more likely to be exposed to tobacco smoke. Wheeze status was ascertained at age 5 years in 162 (77%) children with wheeze at 2 years of age. Whistle persisted in 47% of affected children, rattle in 20%, and purr in 13% (p = 0.023). At 5 years of age, asthma medication was prescribed in 40% with whistle, 11% with rattle, and 18% with purr at 2 years of age (p = 0.017).

Conclusions: This study shows different risk factors and outcomes for different respiratory sounds in 2-year-olds: compared with other respiratory sounds, whistle is likely to persist and require asthma treatment in future.

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  • Funding: This study was funded by Asthma UK who was not involved in the study design, the collection, analysis, and interpretation of data, the writing of the report or the decision to submit the paper for publication.

  • Competing interests: None.