Published online December 1, 2008
PEDIATRICS Vol. 122 No. 6 December 2008, pp. 1171-1176 (doi:10.1542/10.1542/peds.2007-3139)
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ARTICLE

Prevalence and Impact of Respiratory Viral Infections in Young Children With Cystic Fibrosis: Prospective Cohort Study

Bart E. van Ewijk, MDa,b, Marieke M. van der Zalm, MDa,b, Tom F. W. Wolfs, PhDc, Andre Fleer, PhDc, Jan L. L. Kimpen, PhDc, Berry Wilbrink, PhDd and Cornelis K. van der Ent, PhDa,b

a Cystic Fibrosis Centre and Departments of
b Pediatric Respiratory Medicine
c Pediatric Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
d Laboratory for Infectious Diseases and Screening, National Institute of Public Health and the Environment, Bilthoven, Netherlands

OBJECTIVE. We aimed to investigate differences in upper and lower respiratory tract symptoms in relation to respiratory viral infections detected with polymerase chain reaction assays in young children with cystic fibrosis and healthy control subjects.

METHODS. In a 6-month winter period, 20 young children with cystic fibrosis and 18 age-matched, healthy, control subjects were contacted twice per week for detection of symptoms of an acute respiratory illness. If any symptom was present, then a home visit was made for physical examination and collection of nasopharyngeal swabs for viral analysis. In addition, parents were instructed to collect nasopharyngeal swabs every 2 weeks.

RESULTS. Children with cystic fibrosis and healthy control subjects had similar frequencies of acute respiratory illnesses (3.8 ± 1.0 and 4.2 ± 1.7 episodes, respectively). Although there were no significant differences in upper respiratory tract symptoms, the children with cystic fibrosis had longer periods of lower respiratory tract symptoms (22.4 ± 22.2 vs 12.8 ± 13.8 days) and a higher mean severity score per episode (2.35 ± 0.64 vs 1.92 ± 0.46). In addition, similar increases in upper respiratory tract symptom scores were associated with significantly greater increases in lower respiratory tract symptom scores in children with cystic fibrosis. No differences in the seasonal occurrences and distributions of respiratory viruses were observed, with picornaviruses and coronaviruses being the most prevalent.

CONCLUSIONS. Although there were no differences in the seasonal occurrences and distributions of polymerase chain reaction-detected respiratory viruses, acute respiratory illnesses were frequently associated with increased lower respiratory tract morbidity in young children with cystic fibrosis.

Key Words: cystic fibrosis • acute respiratory illness • respiratory tract symptoms • polymerase chain reaction • virus

Abbreviations: ARI—acute respiratory illness • CF—cystic fibrosis • LRTS—lower respiratory tract symptom • PCR—polymerase chain reaction • URTS—upper respiratory tract symptom

Accepted Mar 10, 2008.


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