title: Rhinitis in the first 18 months of life: exploring the role of respiratory viruses.
abstract: BACKGROUND
  Rhinitis is common in early childhood, but allergic rhinitis is considered a later manifestation of the atopic march. This study aimed to evaluate rhinitis (allergic and non-allergic) in the first 18 months of life, its link with other atopic manifestations and the role of respiratory viruses.
  
  
  METHODS
  Subjects (n = 1237) of the Singapore GUSTO birth cohort were followed up quarterly until 18 months of age with questionnaires to screen for rhinitis symptoms lasting at least 2 wk and with monthly calls to positive subjects to detect prolonged/recurrent rhinitis symptoms (total duration ≥ 4 wk). Anterior nasal swabbing for molecular-based virus detection was conducted during these visits and near (within a month) rhinitis episodes. Skin prick testing to common environmental and food allergens was conducted at the 18 month visit.
  
  
  RESULTS
  Prolonged/recurrent rhinitis was significantly associated with history of parental atopy (mother: aOR = 2.17; father: aOR = 1.82) and atopic comorbidities of eczema (aOR = 2.53) and wheeze (aOR = 4.63) (p < 0.05), though not with allergen sensitization. Although the frequency of nasal respiratory virus detection during scheduled quarterly visits did not differ between prolonged/recurrent rhinitis and matched controls (p > 0.05), virus detection was higher in swabs obtained within a month following rhinitis episodes in prolonged/recurrent rhinitis subjects compared with scheduled visits (adjusted p = 0.04).
  
  
  CONCLUSIONS
  Based on the duration of rhinitis symptoms, this study defined a subset of early childhood rhinitis which was associated with atopic predisposition and comorbidities. Persistent respiratory viral shedding may contribute to the symptomatology. Whether this entity is a precursor of subsequent childhood allergic rhinitis will require longer follow-up.
authors.affiliation: Department of Paediatrics, National University of Singapore, Singapore, Singapore.
authors.forename: Antony
authors.initials: A
authors.lastname: Hardjojo
authors.forename: Anne
authors.initials: A
authors.lastname: Goh
authors.forename: Lynette P C
authors.initials: LP
authors.lastname: Shek
authors.forename: Hugo P S
authors.initials: HP
authors.lastname: Van Bever
authors.forename: Oon Hoe
authors.initials: OH
authors.lastname: Teoh
authors.forename: Jian Yi
authors.initials: JY
authors.lastname: Soh
authors.forename: Biju
authors.initials: B
authors.lastname: Thomas
authors.forename: Boon Huan
authors.initials: BH
authors.lastname: Tan
authors.forename: Yiong Huak
authors.initials: YH
authors.lastname: Chan
authors.forename: Mahesh Babu
authors.initials: MB
authors.lastname: Ramamurthy
authors.forename: Daniel Y T
authors.initials: DY
authors.lastname: Goh
authors.forename: Shu-E
authors.initials: SE
authors.lastname: Soh
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kwek
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gluckman
authors.forename: Bee Wah
authors.initials: BW
authors.lastname: Lee
mesh_terms: D000485:Allergens / Q000276:immunology; D015331:Cohort Studies; D004198:Disease Susceptibility; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012008:Recurrence; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D065631:Rhinitis, Allergic / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D012846:Singapore; D012882:Skin Tests; D014780:Viruses / Q000276:immunology* / Q000302:isolation & purification
chemical_list: D000485:Allergens
keywords: birth cohort; infants; quality of life; respiratory virus; rhinitis