Children hospitalized with bronchiolitis caused by other viruses than RSV develop recurrent wheezing at even higher rates than with RSV

Bronchiolitis is a common disease in infancy most commonly caused by respiratory syncytial virus (RSV, also known as human pneumovirus). Other viruses which may cause this illness include metapneumovirus, influenza, parainfluenza, coronavirus, adenovirus, and rhinovirus.

Recent studies have suggested that rhinovirus-associated early wheezing is a greater risk factor for development of recurrent wheezing in children than is early wheezing associated with respiratory syncytial virus (RSV). Respiratory tract viruses have emerged as the most frequent triggers for exacerbations in both children and adults (JACI, 2011).

Transmission electron micrograph of RSV. Source: Wikipedia, CDC, public domain.

A chest X-ray demonstrating lung hyperinflation with a flattened diaphragm and bilateral atelectasis in the right apical and left basal regions in a 16-day-old infant with severe bronchiolitis. Image source: Wikipedia, Creative Commons Attribution 2.0 License.

This study identified retrospectively all children younger than 2 years of age who were admitted to a hospital with bronchiolitis 1988-2001.

Within the first year after hospitalization, 16.6% children with non-RSV bronchiolitis developed recurrent wheezing, compared with 2.5% children with RSV bronchiolitis.

The rates of recurrent wheezing were significantly increased in the non-RSV group also within 2 years and 3 years after hospitalization.

The authors concluded that children hospitalized with bronchiolitis caused by other viruses than RSV develop recurrent wheezing at substantially higher rates during a 3-year follow-up period than do children with RSV-induced bronchiolitis.

Transmission electron micrograph of parainfluenza virus. Two intact particles and free filamentous nucleocapsid. Image source: Wikipedia, CDC, public domain.

Coronavirus. Image source: Wikipedia, public domain.

Molecular surface of a rhinovirus, showing protein spikes. Image source: Wikipedia, GNU Free Documentation License, Version 1.2.

Allergic sensitization is associated with rhinovirus-, but not other virus-, induced wheezing in children.

Recurrent wheezing after respiratory syncytial virus or non-respiratory syncytial virus bronchiolitis in infancy: a 3-year follow-up. Valkonen H, Waris M, Ruohola A, Ruuskanen O, Heikkinen T. Allergy. 2009 Mar 23.
Robert Merritt Chanock - Paediatrician and virologist who identified human respiratory syncytial virus. The Lancet
A simple clinical prediction rule identifies healthy newborns at risk of RSV Bronchiolitis in Healthy Newborns
Rhinoviruses: markers of, or causative for, recurrent wheeze and asthma? ERJ 2012.
Bronchiolitis, from Wikipedia, the free encyclopedia.

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