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Role of viral infections in asthma and allergy

1983; Humana Press; Volume: 1; Issue: 1 Linguagem: Inglês

10.1007/bf02991314

2168-8168

Oscar L. Frick,

Viral gastroenteritis research and epidemiology

An association between virus infections and asthmatic attacks has been recognized at least since Maimonides '1 observation (c.1170 A.D.), "I conclude that this disorder (asthma) starts with a common cold, especially in the rainy season, and the patient is forced to gasp for breath day and night."However, in 1918 Rackemann 2 observed that "150 cases of asthma can nearly all be divided, according to the etiology of their attacks, into... 'extrinsic asthma' due to inhaled antigens or 'intrinsic asthma' in which infectious agents sensitized the bronchial mucosa."In 1962, Freeman and Todd 3 reported in a retrospective study that of 357 hospitalized children with viral respiratory infections proved by positive viral isolates on cultures, 27% wheezed during the virus infection.Especially in children under age 2, wheezing occurred in infections with respiratory syncytial virus (RSV) (52%), parainfluenza (21%), and adenoviruses (13%).In a 20-month mean follow-up, 50% of the children who wheezed with the viral infection, especially those with parainfluenza, subsequently developed asthma or other allergies, whereas this occurred in only 17% of the children who did not wheeze with the virus infection.Boesen 4 observed that, when asthmatic bronchitis occurred under age 1, later allergy occurred only rarely, whereas if it occurred between ages 1 and 3 or over 3 years, later asthma occurred in 25% and 50%, respectively.These studies suggested that early virus-induced asthmatic bronchitis was associated with later development of asthma and other allergies.Three reports in the late 1950s associated outbreaks of Asian infuenza in camps with epidemics of wheezing or asthma, s-7Berkovich et al. 8 associated wheezing, by serologic evidence of infection, with various respiratory viruses or Mycoplasma in 27 of 84 asthmatic children; they also found it almost equally in one-third of children who had influenza type A2 or parainfluenza viruses and in one-fourth of children with Mycoplasma pneumoniae.Severe respiratory distress was observed more frequently during wheezing episodes associated with virus and/or Mycoplasma infections.The definitive landmark studies of McIntosh et al. 9 and Minor et al. 1° in 1973 and 1974 established the association between virus infections and wheez-