Study finds bronchiolitis severity depends on the virus, and questions the practice of rooming children together
A 16-hospital study, led by researchers at Boston Children’s Hospital and Massachusetts General Hospital, is challenging common wisdom about bronchiolitis, a respiratory illness and the leading cause of hospitalization in infants. Currently, clinicians treating babies with severe bronchiolitis generally don’t test for pathogens, assuming the specific infectious cause to be irrelevant to the child’s care. The new study, the largest prospective, multicenter study of U.S. children hospitalized with bronchiolitis, suggests it should be viewed as more than one disease, especially when considering treatments.
“Our data show that the infecting pathogen in bronchiolitis affects hospital length-of-stay,” says Jonathan Mansbach, MD, a hospitalist physician at Boston Children’s and first author of the study, published online April 2 by the Archives of Pediatrics & Adolescent Medicine. “Most research on treatments currently lumps all children with bronchiolitis together, and may miss findings that are important in a particular subgroup.”
Mansbach and senior investigator Carlos A. Camargo, MD, DrPH, of Massachusetts General Hospital, tracked more than 2,200 children under age 2 who were hospitalized with bronchiolitis during the 2007 to 2010 winter seasons, as part of the Multicenter Airway Research Collaboration (MARC), a program of the Emergency Medicine Network (EMNet) (www.emnet-usa.org). PCR testing was done for multiple viruses and bacteria.
While most infants in the study had respiratory syncytial virus (RSV), a quarter were infected with the common cold virus (rhinovirus). These infants were less likely than those with RSV to have hospital stays of three days or longer (odds ratio, 0.36). Compared with infants infected with RSV alone, infants with rhinovirus alone were less likely to have hospital stays of three days or longer (odds ratio, 0.36) after adjustment for other factors affecting disease severity. Infants with both RSV and rhinovirus were morelikely to have 3-day or longer stays than infants with RSV alone (odds ratio, 1.33).
“There seems to be some interaction between RSV and rhinovirus that needs further study,” Mansbach says.
The findings also call into question a common hospital practice of rooming babies with RSV bronchiolitis together. Although this practice is frequently necessary, it has the potential to expose children to new infections. In the study, at least one other virus was detected in 32 percent of the RSV-positive babies and in 23 percent of RSV-negative babies. And some of the co-infecting pathogens require different kinds of infection-control precautions in the hospital, Mansbach says.
Currently, there is much variability in how babies with bronchiolitis are treated, with nothing consistently proven to be beneficial aside from supportive measures. Under a new five-year grant, Mansbach and colleagues have begun a study to test and track children hospitalized with bronchiolitis prospectively, to see if the type of infecting virus, among many other factors, predicts long-term outcomes such as recurrent wheezing at age 3 or asthma at age 6.
Provided by Children's Hospital Boston
- Scientists find predisposition to bronchiolitis in some babies Oct 19, 2007 | not rated yet | 0
- Household smoke increases severity of bronchiolitis in babies Jul 20, 2011 | not rated yet | 0
- New agent strikes at respiratory syncytial virus replication May 05, 2008 | not rated yet | 0
- Common virus can lead to life-threatening conditions in children Mar 19, 2012 | not rated yet | 0
- Common childhood virus packs an increasingly potent punch Jan 05, 2009 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
As the world prepares for what may be the next pandemic strain of influenza virus, in the H7N9 bird flu, a new UC Irvine study reveals that the 2009 H1N1 swine flu pandemic was deadliest for people under the age of 65, while ...
Diseases, Conditions, Syndromes 11 hours ago | not rated yet | 0
The World Health Organization says the Horn of Africa is experiencing an outbreak of polio with cases confirmed in Kenya and Somalia.
Diseases, Conditions, Syndromes 12 hours ago | not rated yet | 0
A man who had contracted the coronavirus has died in Saudi Arabia, raising the death toll in the kingdom from the SARS-like virus to 17, the health ministry announced on its website on Wednesday.
Diseases, Conditions, Syndromes 12 hours ago | not rated yet | 0
A new approach for immunizing against influenza elicited a more potent immune response and broader protection than the currently licensed seasonal influenza vaccines when tested in mice and ferrets. The vaccine ...
Diseases, Conditions, Syndromes 13 hours ago | not rated yet | 0 |
Patients with underlying heart failure are more likely to experience adverse outcomes from mild hypothyroidism, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & ...
Diseases, Conditions, Syndromes 15 hours ago | not rated yet | 0
Swiss scientists reveal the mechanism responsible for aging hidden deep within mitochondria—and dramatically slow it down in worms by administering antibiotics to the young.
15 hours ago | 4.9 / 5 (7) | 0 |
Researchers from Queen Mary, University of London have led the largest sequencing study of human disease to date, investigating the genetic basis of six autoimmune diseases.
15 hours ago | 4.7 / 5 (3) | 0 |
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
12 hours ago | 5 / 5 (2) | 2 |
Existing research shows that bicyclists who wear helmets have an 88 percent lower risk of brain injury, but researchers at Boston Children's Hospital found that simply having bicycle helmet laws in place showed a 20 percent ...
4 hours ago | not rated yet | 0
(HealthDay)—Migraines and depression can each cause a great deal of suffering, but new research indicates the combination of the two may be linked to something else entirely—a smaller brain.
12 hours ago | 4 / 5 (2) | 0 |
In a series of lab experiments designed to unravel the workings of a key enzyme widely considered a possible trigger of rheumatoid arthritis, researchers at Johns Hopkins have found that in the most severe ...
14 hours ago | 5 / 5 (1) | 0 |