title: Clinical Features, Virus Identification, and Sinusitis as a Complication of Upper Respiratory Tract Illness in Children Ages 4-7 Years.
abstract: OBJECTIVE
  To determine the rate of sinusitis complicating upper respiratory tract illnesses (URIs) in children. We prospectively identified the clinical, virologic, and epidemiologic characteristics of URIs in a population of 4- to 7-year-old children followed for 1 year.
  
  
  METHODS
  This was an observational cohort study in 2 primary care pediatric practices in Madison, Wisconsin. Nasal samples were obtained during 4 asymptomatic surveillance visits and during symptomatic URIs. A polymerase chain reaction-based assay for 9 respiratory viruses was performed on nasal samples. A diagnosis of sinusitis was based on published criteria.
  
  
  RESULTS
  Two hundred thirty-six children ages 48-96 months were enrolled. A total of 327 URIs were characterized. The mean number of URIs per child was 1.3 (range 0-9) per year. Viruses were detected in 81% of URIs; rhinovirus (RV) was most common. Seventy-two percent of URIs were resolved clinically by the 10th day. RV-A and RV-C were detected more frequently at URI visits; RV-B was detected at the same rate for both asymptomatic surveillance visits and URI visits. Sinusitis was diagnosed in 8.8% of symptomatic URIs. Viruses were detected frequently (33%) in samples from asymptomatic children.
  
  
  CONCLUSIONS
  Sinusitis occurred in 8.8% of symptomatic URIs in our study. The virus most frequently detected with URIs in children was RV; RV-A and RV-C detection but not RV-B detection were associated with illness. Viruses, especially RV, are detected frequently in asymptomatic children. Most URIs have improved or resolved by the 10th day after onset. Children experienced a mean of 1.3 URIs per year, which was lower than expected.
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: DeMuri
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: James E
authors.initials: JE
authors.lastname: Gern
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Stacey C
authors.initials: SC
authors.lastname: Moyer
authors.affiliation: Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Lindstrom
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA.
authors.forename: Susan V
authors.initials: SV
authors.lastname: Lynch
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Wald
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D009666:Nose / Q000821:virology; D016133:Polymerase Chain Reaction; D012141:Respiratory Tract Infections / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D012229:Rhinovirus / Q000302:isolation & purification; D012621:Seasons; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D014922:Wisconsin