title: Human enterovirus and rhinovirus infections are associated with otitis media in a prospective birth cohort study.
abstract: Human enteroviruses (HEVs) and rhinoviruses (HRVs) have been linked to acute otitis media (AOM).
  
  
  
  The present study evaluates the aforementioned association in a birth cohort setting.
  
  
  
  The cohort included 286 healthy infants (191 boys) followed from birth up to the age of 2 years in the Type 1 Diabetes Prediction and Prevention study in Finland. Stool samples were collected monthly and analyzed for the presence of HRV and HEV RNA using RT-PCR. Clinical symptoms were recorded by a questionnaire every 3-6 months.
  
  
  
  Altogether 610 AOM episodes were reported during the follow-up. 9.8% of the stool samples were positive for HRV and 6.8% for HEV. HRV positivity peaked at the age of 3-6 months declining gradually after this age, whereas HEV positivity peaked later, at the age of 12-24 months. The risk of AOM was increased in children who were HEV positive at least once at the age of 6-12 months (OR 2.2 [95%CI 1.1-4.2], P=0.023) or who were HRV positive at least once at the age of 18-24 months (OR 2.3 [95%CI 1.0-5.2], P=0.042). Having an older sibling, short breast-feeding and maternal smoking during pregnancy were also significantly associated with AOM.
  
  
  
  HRV and HEV infections are frequent during the first months of life. The observed trend for increased risk of AOM in HRV and HEV positive children is in line with the results from hospital series suggesting that these viruses may play an independent role in the pathogenesis of AOM.
authors: School of Medicine, University of Tampere, Lääkärinkatu 1, FIN-33520, Tampere, Finland. Electronic address: seppala.elina.m@student.uta.fi.
authors: Elina
authors: E
authors: Seppälä
authors: Department of Anatomy, School of Medicine, University of Tampere, Finland; Department of Otorhinolaryngology, Head and Neck Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Finland.
authors: Saara
authors: S
authors: Sillanpää
authors: School of Medicine, University of Tampere, Lääkärinkatu 1, FIN-33520, Tampere, Finland.
authors: Noora
authors: N
authors: Nurminen
authors: School of Health Sciences, University of Tampere, Tampere, Finland.
authors: Heini
authors: H
authors: Huhtala
authors: Department of Physiology, University of Turku, Turku, Finland; Department of Pediatrics, Turku University Hospital, Turku, Finland.
authors: Jorma
authors: J
authors: Toppari
authors: Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland.
authors: Jorma
authors: J
authors: Ilonen
authors: Department of Pediatrics, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
authors: Riitta
authors: R
authors: Veijola
authors: Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Tampere Center for Child Health Research, Tampere University Hospital, Tampere, Finland.
authors: Mikael
authors: M
authors: Knip
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Finland.
authors: Markku
authors: M
authors: Sipilä
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Finland.
authors: Jussi
authors: J
authors: Laranne
authors: School of Medicine, University of Tampere, Lääkärinkatu 1, FIN-33520, Tampere, Finland.
authors: Sami
authors: S
authors: Oikarinen
authors: School of Medicine, University of Tampere, Lääkärinkatu 1, FIN-33520, Tampere, Finland; Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland.
authors: Heikki
authors: H
authors: Hyöty
mesh_terms: D002675:Child, Preschool; D004770:Enterovirus / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000453:epidemiology*; D005243:Feces / Q000821:virology; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010033:Otitis Media / Q000453:epidemiology* / Q000821:virology*; D010850:Picornaviridae Infections / Q000453:epidemiology*; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012229:Rhinovirus / Q000302:isolation & purification*; D011795:Surveys and Questionnaires
chemical_list: D012367:RNA, Viral
keywords: Acute otitis media; Children; Picornaviruses