Symptomatic and asymptomatic respiratory viral infections in the first year of life

association with acute otitis media development

Tasnee Chonmaitree, Pedro Alvarez-Fernandez, Kristofer Jennings, Rocio Trujillo, Tal Marom, Michael J. Loeffelholz, Aaron L. Miller, David P. McCormick, Janak Patel, Richard Pyles

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

BACKGROUND: Sensitive diagnostic assays have increased the detection of viruses in asymptomatic individuals. The clinical significance of asymptomatic respiratory viral infection in infants is unknown.

METHODS: High-throughput, quantitative polymerase chain reaction assays were used to detect 13 common respiratory viruses from nasopharyngeal specimens collected during 2028 visits from 362 infants followed from near birth up to 12 months of age. Specimens were collected at monthly interval (months 1-6 and month 9) and during upper respiratory tract infection (URTI) episodes. Subjects were followed closely for acute otitis media (AOM) development.

RESULTS: Viruses were detected in 76% of 394 URTI specimens and 27% of asymptomatic monthly specimens. Rhinovirus was detected most often; multiple viruses were detected in 29% of the specimens. Generalized mixed-model analyses associated symptoms with increasing age and female sex; detection of respiratory syncytial virus (RSV), influenza, rhinovirus, metapneumovirus, and adenovirus was highly associated with symptoms. Increasing age was also associated with multiple virus detection. Overall, 403 asymptomatic viral infections in 237 infants were identified. Viral load was significantly higher in URTI specimens than asymptomatic specimens but did not differentiate cases of URTI with and without AOM complication. The rate of AOM complicating URTI was 27%; no AOM occurred following asymptomatic viral infections. AOM development was associated with increasing age and infection with RSV, rhinovirus, enterovirus, adenovirus, and bocavirus.

CONCLUSIONS: Compared to symptomatic infection, asymptomatic viral infection in infants is associated with young age, male sex, low viral load, specific viruses, and single virus detection. Asymptomatic viral infection did not result in AOM.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume60
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Otitis Media
Virus Diseases
Respiratory Tract Infections
Asymptomatic Infections
Viruses
Rhinovirus
Viral Load
Adenoviridae
Bocavirus
Metapneumovirus
Respiratory Syncytial Virus Infections
Respiratory Syncytial Viruses
Enterovirus
Human Influenza
Parturition
Polymerase Chain Reaction

Keywords

  • acute otitis media
  • asymptomatic infection
  • common cold
  • respiratory viruses
  • rhinovirus

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Symptomatic and asymptomatic respiratory viral infections in the first year of life : association with acute otitis media development. / Chonmaitree, Tasnee; Alvarez-Fernandez, Pedro; Jennings, Kristofer; Trujillo, Rocio; Marom, Tal; Loeffelholz, Michael J.; Miller, Aaron L.; McCormick, David P.; Patel, Janak; Pyles, Richard.

In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol. 60, No. 1, 01.01.2015, p. 1-9.

Research output: Contribution to journalArticle

Chonmaitree, Tasnee ; Alvarez-Fernandez, Pedro ; Jennings, Kristofer ; Trujillo, Rocio ; Marom, Tal ; Loeffelholz, Michael J. ; Miller, Aaron L. ; McCormick, David P. ; Patel, Janak ; Pyles, Richard. / Symptomatic and asymptomatic respiratory viral infections in the first year of life : association with acute otitis media development. In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2015 ; Vol. 60, No. 1. pp. 1-9.
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AU - Chonmaitree, Tasnee

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AU - Jennings, Kristofer

AU - Trujillo, Rocio

AU - Marom, Tal

AU - Loeffelholz, Michael J.

AU - Miller, Aaron L.

AU - McCormick, David P.

AU - Patel, Janak

AU - Pyles, Richard

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N2 - BACKGROUND: Sensitive diagnostic assays have increased the detection of viruses in asymptomatic individuals. The clinical significance of asymptomatic respiratory viral infection in infants is unknown.METHODS: High-throughput, quantitative polymerase chain reaction assays were used to detect 13 common respiratory viruses from nasopharyngeal specimens collected during 2028 visits from 362 infants followed from near birth up to 12 months of age. Specimens were collected at monthly interval (months 1-6 and month 9) and during upper respiratory tract infection (URTI) episodes. Subjects were followed closely for acute otitis media (AOM) development.RESULTS: Viruses were detected in 76% of 394 URTI specimens and 27% of asymptomatic monthly specimens. Rhinovirus was detected most often; multiple viruses were detected in 29% of the specimens. Generalized mixed-model analyses associated symptoms with increasing age and female sex; detection of respiratory syncytial virus (RSV), influenza, rhinovirus, metapneumovirus, and adenovirus was highly associated with symptoms. Increasing age was also associated with multiple virus detection. Overall, 403 asymptomatic viral infections in 237 infants were identified. Viral load was significantly higher in URTI specimens than asymptomatic specimens but did not differentiate cases of URTI with and without AOM complication. The rate of AOM complicating URTI was 27%; no AOM occurred following asymptomatic viral infections. AOM development was associated with increasing age and infection with RSV, rhinovirus, enterovirus, adenovirus, and bocavirus.CONCLUSIONS: Compared to symptomatic infection, asymptomatic viral infection in infants is associated with young age, male sex, low viral load, specific viruses, and single virus detection. Asymptomatic viral infection did not result in AOM.

AB - BACKGROUND: Sensitive diagnostic assays have increased the detection of viruses in asymptomatic individuals. The clinical significance of asymptomatic respiratory viral infection in infants is unknown.METHODS: High-throughput, quantitative polymerase chain reaction assays were used to detect 13 common respiratory viruses from nasopharyngeal specimens collected during 2028 visits from 362 infants followed from near birth up to 12 months of age. Specimens were collected at monthly interval (months 1-6 and month 9) and during upper respiratory tract infection (URTI) episodes. Subjects were followed closely for acute otitis media (AOM) development.RESULTS: Viruses were detected in 76% of 394 URTI specimens and 27% of asymptomatic monthly specimens. Rhinovirus was detected most often; multiple viruses were detected in 29% of the specimens. Generalized mixed-model analyses associated symptoms with increasing age and female sex; detection of respiratory syncytial virus (RSV), influenza, rhinovirus, metapneumovirus, and adenovirus was highly associated with symptoms. Increasing age was also associated with multiple virus detection. Overall, 403 asymptomatic viral infections in 237 infants were identified. Viral load was significantly higher in URTI specimens than asymptomatic specimens but did not differentiate cases of URTI with and without AOM complication. The rate of AOM complicating URTI was 27%; no AOM occurred following asymptomatic viral infections. AOM development was associated with increasing age and infection with RSV, rhinovirus, enterovirus, adenovirus, and bocavirus.CONCLUSIONS: Compared to symptomatic infection, asymptomatic viral infection in infants is associated with young age, male sex, low viral load, specific viruses, and single virus detection. Asymptomatic viral infection did not result in AOM.

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KW - asymptomatic infection

KW - common cold

KW - respiratory viruses

KW - rhinovirus

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