Study finds bronchiolitis severity depends on the virus, and questions the practice of rooming children together

April 4, 2012

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 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.

Explore further: Household smoke increases severity of bronchiolitis in babies

Related Stories

Household smoke increases severity of bronchiolitis in babies

July 20, 2011
A study by the University of Liverpool has found that babies admitted to hospital with bronchiolitis from a household where a parent smokes are twice as likely to need oxygen therapy and five times as likely to need mechanical ...

Common virus can lead to life-threatening conditions in children

March 19, 2012
(Medical Xpress) -- Respiratory Syncytial Virus (RSV) is a common virus that infects the lungs and breathing passage ways. Though it may only produce minor cold symptoms in adults, it can lead to serious illness in young ...

Recommended for you

Google searches can be used to track dengue in underdeveloped countries

July 20, 2017
An analytical tool that combines Google search data with government-provided clinical data can quickly and accurately track dengue fever in less-developed countries, according to new research published in PLOS Computational ...

MRSA emerged years before methicillin was even discovered

July 19, 2017
Methicillin resistant Staphylococcus aureus (MRSA) emerged long before the introduction of the antibiotic methicillin into clinical practice, according to a study published in the open access journal Genome Biology. It was ...

New test distinguishes Zika from similar viral infections

July 18, 2017
A new test is the best-to-date in differentiating Zika virus infections from infections caused by similar viruses. The antibody-based assay, developed by researchers at UC Berkeley and Humabs BioMed, a private biotechnology ...

'Superbugs' study reveals complex picture of E. coli bloodstream infections

July 18, 2017
The first large-scale genetic study of Escherichia coli (E. coli) cultured from patients with bloodstream infections in England showed that drug resistant 'superbugs' are not always out-competing other strains. Research by ...

Ebola virus can persist in monkeys that survived disease, even after symptoms disappear

July 17, 2017
Ebola virus infection can be detected in rhesus monkeys that survive the disease and no longer show symptoms, according to research published by Army scientists in today's online edition of the journal Nature Microbiology. ...

Mountain gorillas have herpes virus similar to that found in humans

July 13, 2017
Scientists from the University of California, Davis, have detected a herpes virus in wild mountain gorillas that is very similar to the Epstein-Barr virus in humans, according to a study published today in the journal Scientific ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.