Rhinitis, sinusitis, and ocular diseases
The September epidemic of asthma exacerbations in children: A search for etiology

https://doi.org/10.1016/j.jaci.2004.09.025Get rights and content

Background

Predictable peaks of asthma exacerbation requiring hospital treatment, of greatest magnitude in children and of uncertain etiology, occur globally after school returns.

Objective

We wished to determine whether asthmatic children requiring emergency department treatment for exacerbations after school return in September were more likely to have respiratory viruses present and less likely to have prescriptions for control medications than children with equally severe asthma not requiring emergent treatment.

Methods

Rates of viral detection and characteristics of asthma management in 57 (of 60) children age 5 to 15 years presenting to emergency departments with asthma in 2 communities in Canada between September 10 and 30, 2001, (cases) were compared with those in 157 age-matched volunteer children with asthma of comparable severity studied simultaneously (controls).

Results

Human picornaviruses were detected in 52% of cases and 29% of controls (P = .002) and viruses of any type in 62% of cases and 41% of controls (P = .011). Cases were less likely to have been prescribed controller medication (inhaled corticosteroid, 49% vs 85%; P < .0001; leukotriene receptor antagonist, 9% vs 21%; P = .04).

Conclusion

Respiratory viruses were detected in the majority of children presenting to emergency departments with asthma during the September epidemic of the disease and in a significant minority of children with asthma in the community. The latter were more likely to have anti-inflammatory medication prescriptions than children requiring emergent treatment. Such medication may reduce the risk of emergency department treatment for asthma during the September epidemic.

Key words

Asthma
children
viral infections
rhinovirus
school return
inhaled corticosteroid
leukotriene receptor antagonist

Cited by (0)

Supported by Merck-Frosst Canada Limited.

View Abstract