The September epidemic of asthma exacerbations in children: A search for etiology
Open accessAbstract
Background Predictable peaks of asthma exacerbation requiring hospital treatment, of greatest magnitude in children and of uncertain etiology, occur globally after school returns.Objective We wished to determine whether asthmatic children requiring emergency department treatment for exacerbations after school return in September were more likely to have respiratory viruses present and less likely to have prescriptions for control medications than children with equally severe asthma not requiring emergent treatment.Methods Rates of viral detection and characteristics of asthma management in 57 (of 60) children age 5 to 15 years presenting to emergency departments with asthma in 2 communities in Canada between September 10 and 30, 2001, (cases) were compared with those in 157 age-matched volunteer children with asthma of comparable severity studied simultaneously (controls).Results Human picornaviruses were detected in 52% of cases and 29% of controls ( P = .002) and viruses of any type in 62% of cases and 41% of controls ( P = .011). Cases were less likely to have been prescribed controller medication (inhaled corticosteroid, 49% vs 85%; P < .0001; leukotriene receptor antagonist, 9% vs 21%; P = .04).Conclusion Respiratory viruses were detected in the majority of children presenting to emergency departments with asthma during the September epidemic of the disease and in a significant minority of children with asthma in the community. The latter were more likely to have anti-inflammatory medication prescriptions than children requiring emergent treatment. Such medication may reduce the risk of emergency department treatment for asthma during the September epidemic.
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Clinical studies have shown that respiratory viruses increase the incidence and severity of severe secondary bacterial complications.
“Clinical studies have shown that respiratory viruses increase the incidence and severity of severe secondary bacterial complications (130, 207, 330).”
From The airway epithelium: soldier in the fight against respiratory viruses (2011) · cites this paper as [130]
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The airway epithelium: soldier in the fight against respiratory viruses
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Self-citation
- Authors
- Johnston, N. W., Johnston, S. L., Duncan, J. M., Greene, J. M., Kebadze, T., Keith, P. K., Roy, M., Waserman, S., & Sears, M. R.
- Affiliations
- McMaster University (CA)
- Imperial College London (GB)
- Brant Community Healthcare System (CA)
- Corresponding author
- Johnston, Neil W.
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2005-01
- Volume
- 115
- Issue
- 1
- Pages
- 132-138
- ISSN
- 0091-6749 (ISSN-L)
- PMC
- PMC7202457
- OpenAlex
- W2071295142
- Cited by
- 343
- References
- 35
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 8 · 2023: 10 · 2022: 8 · 2021: 18 · 2020: 15 · 2019: 17 · 2018: 19 · 2017: 16 · 2016: 17 · 2015: 17 · 2014: 19 · 2013: 23 · 2012: 17
- FWCI
- 12.39
- Type
- journal article
- Language
- en
- Update notices
- erratum (2007-08-01)
- Open access
- bronze
- doi.org
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Keywords
- asthma exacerbations, childhood asthma, school return, respiratory viruses, emergency department visits, controller medications, inhaled corticosteroids, leukotriene receptor antagonists, asthma management
- MeSH terms
- Administration, Inhalation, Adolescent, Asthma, Canada, Child, Child, Preschool, Female, Hospitals, Humans, Hydroxycorticosteroids, Male, Picornaviridae, Picornaviridae Infections, Surveys and Questionnaires, Risk Factors, Seasons, Anti-Asthmatic Agents, Leukotriene Antagonists
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