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Symptomatic and asymptomatic respiratory viral infections in the first year of life: association with acute otitis media development.
Clin Infect Dis. 2015 Jan 01; 60(1):1-9.CI

Abstract

BACKGROUND

Sensitive diagnostic assays have increased the detection of viruses in asymptomatic individuals. The clinical significance of asymptomatic respiratory viral infection in infants is unknown.

METHODS

High-throughput, quantitative polymerase chain reaction assays were used to detect 13 common respiratory viruses from nasopharyngeal specimens collected during 2028 visits from 362 infants followed from near birth up to 12 months of age. Specimens were collected at monthly interval (months 1-6 and month 9) and during upper respiratory tract infection (URTI) episodes. Subjects were followed closely for acute otitis media (AOM) development.

RESULTS

Viruses were detected in 76% of 394 URTI specimens and 27% of asymptomatic monthly specimens. Rhinovirus was detected most often; multiple viruses were detected in 29% of the specimens. Generalized mixed-model analyses associated symptoms with increasing age and female sex; detection of respiratory syncytial virus (RSV), influenza, rhinovirus, metapneumovirus, and adenovirus was highly associated with symptoms. Increasing age was also associated with multiple virus detection. Overall, 403 asymptomatic viral infections in 237 infants were identified. Viral load was significantly higher in URTI specimens than asymptomatic specimens but did not differentiate cases of URTI with and without AOM complication. The rate of AOM complicating URTI was 27%; no AOM occurred following asymptomatic viral infections. AOM development was associated with increasing age and infection with RSV, rhinovirus, enterovirus, adenovirus, and bocavirus.

CONCLUSIONS

Compared to symptomatic infection, asymptomatic viral infection in infants is associated with young age, male sex, low viral load, specific viruses, and single virus detection. Asymptomatic viral infection did not result in AOM.

Authors+Show Affiliations

Departments of Pediatrics Pathology.Departments of Pediatrics.Preventive Medicine and Community Health.Departments of Pediatrics.Departments of Pediatrics.Pathology.Departments of Pediatrics.Departments of Pediatrics.Departments of Pediatrics.Departments of Pediatrics Microbiology and Immunology, University of Texas Medical Branch, Galveston.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25205769

Citation

Chonmaitree, Tasnee, et al. "Symptomatic and Asymptomatic Respiratory Viral Infections in the First Year of Life: Association With Acute Otitis Media Development." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 60, no. 1, 2015, pp. 1-9.
Chonmaitree T, Alvarez-Fernandez P, Jennings K, et al. Symptomatic and asymptomatic respiratory viral infections in the first year of life: association with acute otitis media development. Clin Infect Dis. 2015;60(1):1-9.
Chonmaitree, T., Alvarez-Fernandez, P., Jennings, K., Trujillo, R., Marom, T., Loeffelholz, M. J., Miller, A. L., McCormick, D. P., Patel, J. A., & Pyles, R. B. (2015). Symptomatic and asymptomatic respiratory viral infections in the first year of life: association with acute otitis media development. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 60(1), 1-9. https://doi.org/10.1093/cid/ciu714
Chonmaitree T, et al. Symptomatic and Asymptomatic Respiratory Viral Infections in the First Year of Life: Association With Acute Otitis Media Development. Clin Infect Dis. 2015 Jan 1;60(1):1-9. PubMed PMID: 25205769.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Symptomatic and asymptomatic respiratory viral infections in the first year of life: association with acute otitis media development. AU - Chonmaitree,Tasnee, AU - Alvarez-Fernandez,Pedro, AU - Jennings,Kristofer, AU - Trujillo,Rocio, AU - Marom,Tal, AU - Loeffelholz,Michael J, AU - Miller,Aaron L, AU - McCormick,David P, AU - Patel,Janak A, AU - Pyles,Richard B, Y1 - 2014/09/09/ PY - 2014/9/11/entrez PY - 2014/9/11/pubmed PY - 2015/9/1/medline KW - acute otitis media KW - asymptomatic infection KW - common cold KW - respiratory viruses KW - rhinovirus SP - 1 EP - 9 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 60 IS - 1 N2 - BACKGROUND: Sensitive diagnostic assays have increased the detection of viruses in asymptomatic individuals. The clinical significance of asymptomatic respiratory viral infection in infants is unknown. METHODS: High-throughput, quantitative polymerase chain reaction assays were used to detect 13 common respiratory viruses from nasopharyngeal specimens collected during 2028 visits from 362 infants followed from near birth up to 12 months of age. Specimens were collected at monthly interval (months 1-6 and month 9) and during upper respiratory tract infection (URTI) episodes. Subjects were followed closely for acute otitis media (AOM) development. RESULTS: Viruses were detected in 76% of 394 URTI specimens and 27% of asymptomatic monthly specimens. Rhinovirus was detected most often; multiple viruses were detected in 29% of the specimens. Generalized mixed-model analyses associated symptoms with increasing age and female sex; detection of respiratory syncytial virus (RSV), influenza, rhinovirus, metapneumovirus, and adenovirus was highly associated with symptoms. Increasing age was also associated with multiple virus detection. Overall, 403 asymptomatic viral infections in 237 infants were identified. Viral load was significantly higher in URTI specimens than asymptomatic specimens but did not differentiate cases of URTI with and without AOM complication. The rate of AOM complicating URTI was 27%; no AOM occurred following asymptomatic viral infections. AOM development was associated with increasing age and infection with RSV, rhinovirus, enterovirus, adenovirus, and bocavirus. CONCLUSIONS: Compared to symptomatic infection, asymptomatic viral infection in infants is associated with young age, male sex, low viral load, specific viruses, and single virus detection. Asymptomatic viral infection did not result in AOM. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/25205769/Symptomatic_and_asymptomatic_respiratory_viral_infections_in_the_first_year_of_life:_association_with_acute_otitis_media_development_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciu714 DB - PRIME DP - Unbound Medicine ER -