Viral etiology plays a significant role in symptom severity in children with acute respiratory infection, and certain viruses were also associated with an enhanced risk for subsequent acute respiratory infection, according to findings published in the Journal of Infectious Diseases.

Adenovirus, enterovirus D68, human metapneumovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus are common causes of acute respiratory infection in children. However, it is not clear whether viral infection affects the risk for subsequent acute respiratory infection. In the current study, researchers assessed how prior viral infection can lead to an enhanced or decreased risk for subsequent acute respiratory infection in a cohort of 3851 children followed for a mean of 392 days (interquartile range, 168-714 days) with 4547 person-years of follow-up. A total of 16, 337 acute respiratory infection episodes were recorded and nasopharyngeal specimens were collected from 24% of all patients with acute respiratory infection.

In more than half of the samples (56%), at least one respiratory virus was detected (2204/3971). The most frequently identified virus was rhinovirus (n = 867, 22%), followed by respiratory syncytial virus (n = 489, 12%), parainfluenza virus (n = 378, 10%), influenza virus (n = 320, 8%), human metapneumovirus (n = 129, 3%), adenovirus (n = 95, 2%), and enterovirus (n = 93, 2%). Findings showed that children who had preceding infection with adenovirus (hazard ratio [HR] 1.5; 95% CI, 1.0-2.1), influenza virus A (HR 1.3; 95% CI, 1.1-1.7), parainfluenza virus-4 (HR 1.6; 95% CI, 1.0-2.4), and rhinovirus-C (HR 1.3; 95% CI, 1.1-1.6) had a significantly higher risk for subsequent acute respiratory infection. In addition, results also demonstrated that preceding infection with adenovirus, influenza-A, parainfluenza-4, and rhinovirus-C was associated with increased risk for acute respiratory infection.

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“Further study would be required to reveal the risk not only for subsequent [acute respiratory infection] but also for the development of asthma in children after viral infections,” wrote the researchers.

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Furuse Y, Tamaki R, Okamoto M, et al. Association between preceding viral respiratory infection and subsequent respiratory illnesses among children: A prospective cohort study in the Philippines [published online September 5, 2018] J Infect Dis. doi: 10.1093/infdis/jiy515