title: Predominance of rhinovirus in the nose of symptomatic and asymptomatic infants.
abstract: Respiratory infections in infancy may protect against developing Th2-mediated allergic disease (hygiene hypothesis). To estimate the relative contribution of particular viruses to the development of the immune system and allergic disease, we investigated longitudinally the prevalence of respiratory viral infections in infants. One hundred and twenty-six healthy infants were included in this prospective birth cohort study in their first year of life. Physical examination was performed and nasal brush samples were taken during routine visits every 6 months and during an upper respiratory tract infection (URTI) (sick visits). The prevalence of respiratory viral infections in infants with URTI, infants with rhinitis without general malaise and infants without nasal symptoms was studied. Rhinovirus was the most prevalent pathogen during URTI and rhinitis in 0- to 2-year-old infants ( approximately 40%). During URTI, also respiratory syncytial virus ( approximately 20%) and coronavirus ( approximately 10%) infections were found, which were rarely detected in infants with rhinitis. Surprisingly, in 20% of infants who did not present with nasal symptoms, rhinovirus infections were also detected. During routine visits at 12 months, a higher prevalence of rhinovirus infections was found in infants who attended day-care compared with those who did not. We did not observe a relation between breast-feeding or smoking by one or both parents and the prevalence of rhinovirus infections. The parental history of atopy was not related to the prevalence of rhinovirus infection, indicating that the genetic risk of allergic disease does not seem to increase the chance of rhinovirus infections. In conclusion, rhinovirus infection is the most prevalent respiratory viral infection in infants. It may therefore affect the maturation of the immune system and the development of allergic disease considerably.
authors.affiliation: Department of Otorhinolaryngology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Inesz
authors.initials: I
authors.lastname: van Benten
authors.forename: Laurens
authors.initials: L
authors.lastname: Koopman
authors.forename: Bert
authors.initials: B
authors.lastname: Niesters
authors.forename: Wim
authors.initials: W
authors.lastname: Hop
authors.forename: Barbara
authors.initials: B
authors.lastname: van Middelkoop
authors.forename: Leon
authors.initials: L
authors.lastname: de Waal
authors.forename: Kees
authors.initials: K
authors.lastname: van Drunen
authors.forename: Albert
authors.initials: A
authors.lastname: Osterhaus
authors.forename: Herman
authors.initials: H
authors.lastname: Neijens
authors.forename: Wytske
authors.initials: W
authors.lastname: Fokkens
mesh_terms: D000367:Age Factors; D002656:Child Day Care Centers; D002669:Child Welfare; D002675:Child, Preschool; D018352:Coronavirus Infections / Q000453:epidemiology / Q000821:virology; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000821:virology; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000821:virology; D004781:Environmental Exposure; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010850:Picornaviridae Infections / Q000453:epidemiology / Q000821:virology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology / Q000821:virology; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000821:virology*; D012229:Rhinovirus; D012307:Risk Factors; D012720:Severity of Illness Index; D013223:Statistics as Topic