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Viral illness patterns in children differ among urban vs. rural areas
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Children living in low-income urban areas appear especially prone to developing asthma, possibly related to infections they acquire early in life, according to researchers from the University of Wisconsin in Madison.
James E. Gern, MD, and colleagues collected nasal secretions from 515 infants from Boston, Baltimore, New York City and St. Louis and compared them with 285 infants from suburban Madison, Wis. Nasal secretions were sampled during periods when the babies had respiratory illnesses and when they were healthy.
The inner-city infants had lower rates of viral detection overall, the researchers said. This may suggest that other factors, such as bacteria or allergic reactions to pollutions or toxic exposures, contribute significantly to respiratory illness, according to the researchers.
Sick urban infants had higher rates of adenovirus infections, with 4.8% of nasal washes testing positive for only adenovirus, compared with just 0.7% of samples from suburban infants.
The finding on adenovirus is of particular interest, the researchers said, because adenovirus can cause persistent infections. The researchers also suggested that development of the lungs or airways could be altered by adenovirus infections in early life.
In an accompanying editorial, Peter W. Heymann, MD, and Thomas A.E. Platts-Mills, MD, PhD, of the University of Virginia in Charlottesville, said the findings are of interest, given the pervasiveness and the morbidity and mortality of asthma in poor urban areas.
“The results clearly show differences in the detection of viral infections during the first year of life,” they wrote, “and this approach is likely to provide novel insights that will serve to guide the development of treatment interventions to decrease the prevalence and severity of asthma during childhood.”
To better understand the origins of nonviral respiratory illnesses, Gern and colleagues are planning experiments to evaluate other pathogens and microbes in the airways. They also plan to follow the urban children in this study for at least 10 years to “test the hypothesis that infections with adenoviruses might be associated later on in childhood with an increased rate of asthma and perhaps lower levels of lung function.”
Disclosure: Gern reports being a consultant for Biota, Boehringer Ingelheim, Centocor, Gilead, GlaxoSmithKline, MedImmune, Pulmatrix, Synairgen and Theraclone; has research funding from AstraZeneca, GlaxoSmithKline and Merck; and holds stock options in 3V BioSciences.
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