title: High incidence of recurrent wheeze in children with down syndrome with and without previous respiratory syncytial virus lower respiratory tract infection.
abstract: BACKGROUND
  Respiratory syncytial virus (RSV)-induced lower respiratory tract infection (LRTI) is associated with the subsequent development of recurrent wheeze. In a recent study, we found a high incidence (9.9%) of hospitalization for RSV-induced LRTI among children with Down syndrome (DS), indicating DS as a new risk factor for RSV-induced LRTI. In the current study we aimed to investigate the development of long-term airway morbidity in children with DS after hospitalization for RSV-induced LRTI.
  
  
  METHODS
  A combined retrospective cohort and prospective birth cohort of children with DS with a history of hospitalization for RSV-induced LRTI was studied (n = 53). Three control populations were included: children with DS without hospitalization for RSV-induced LRTI (n = 110), children without DS but with hospitalization for RSV-induced LRTI (n = 48), and healthy siblings of the previous 3 groups mentioned (n = 49). The primary outcome was physician-diagnosed wheeze up to 2 years of age.
  
  
  RESULTS
  The incidence of physician-diagnosed recurrent wheeze in children with DS with a history of hospitalization for RSV-induced LRTI was 36%. Unexpectedly, up to 30% of children with DS without a history of RSV-induced LRTI had physician-diagnosed recurrent wheeze (no significant difference). In children without DS physician-diagnosed wheeze was found more frequently in children hospitalized for RSV-induced LRTI than healthy controls (31% vs. 8%, P = 0.004).
  
  
  CONCLUSIONS
  In this combined retrospective/prospective cohort study RSV-induced LRTI did not significantly contribute to the risk of recurrent wheeze in children with DS. An unexpected finding was that recurrent wheeze was very common among children with DS.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht 3508 AB, The Netherlands.
authors.forename: Beatrijs L P
authors.initials: BL
authors.lastname: Bloemers
authors.forename: A Marceline
authors.initials: AM
authors.lastname: van Furth
authors.forename: Michel E
authors.initials: ME
authors.lastname: Weijerman
authors.forename: Reinoud J B J
authors.initials: RJ
authors.lastname: Gemke
authors.forename: Chantal J M
authors.initials: CJ
authors.lastname: Broers
authors.forename: Jan L L
authors.initials: JL
authors.lastname: Kimpen
authors.forename: Louis
authors.initials: L
authors.lastname: Bont
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012135:Respiratory Sounds; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000473:pathology*; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000473:pathology*; D012189:Retrospective Studies