VIRUSES AND ASTHMA. They asked if the sneezle came after the wheezle, or if the first sneezle came first
|
|
- Maryann Armstrong
- 6 years ago
- Views:
Transcription
1 VIRUSES AND ASTHMA They asked if the sneezle came after the wheezle, or if the first sneezle came first
2
3
4 First documented viral-association of asthma attacks occurred during influenza epidemics at 4 th National Boy Scouts Jamboree, Pennsylvania, 1957 followed a month later by the Centenary World Guide Camp, Ontario
5
6 Viruses as precipitants of asthma symptoms: 38 studies 1. Resp viruses identified 5-17x as often in exacerbations as during well intervals; Bacteria similar at both times. 2. Viral Identification rates depended on 1. Virology quality. rhinovirus expertise, and sensitive cell lines (Purpose-selected> hospital available (then)) 2. Intensity of follow-up Proactive monitoring for infections Interval between symptom onset and viral samples (prospective> p.r.n. community>p.r.n. hospital studies) 3. In wheeze episodes Highest rhinovirus ID (by culture) was 31.9% Most intensive study without HRV ID was 48% ~80%
7 Viruses as precipitants of asthma symptoms (2) 4. Every known respiratory virus & M.pneumoniae was found in at least one study, but no study found them all (or had adequate techniques to do so). 5. Double & triple infections were found 6. In prospective studies of children with asthma, wheezing occurred fairly predictably in about 50% of identified infections 7. Virus seroconversion occurred in some wheezing attacks without any other RTI symptoms in Davos (daily exam and spirometry, monthly + acute serology for one year)? asthma exposing an infection that would otherwise be asymptomatic 4. Adult studies were few, poor in virology, numbers and follow-up and showed lower rates of viruses
8 Duration of lung dysfunction after influenza in children with asthma Roldaan & Masural. Eur J Respir Dis 1982;63:
9 Southampton / Common Cold Unit Study Dedicated cohort of symptomatic children in Soton area Development by MRC Common Cold Unit, Harnham Down, Salisbury, of coronavirus and shared-sequence rhinovirus DNA probes, (morphed PCR multiplex assay) Virus cultures, PCR, immunofluorescence, paired sera Daily symptom and peak flow monitoring for a year Germbusters attack force ready to take nasal aspirates, and bloods within 3d of symptom onset Careful computerised definition of episodes Rapid learning curve for putting lid on haemocentrifuge
10 Viruses identified in acute wheeze Para influenza 7% RSV 5% Influenza 9% No virus 18% Coronavirus 8% Multiple viruses In 15 episodes (5%) Rhinovirus 53% Rhinovirus 12% when asymptomatic Johnston, Pattemore et al BMJ 1995;310(6989):
11 Examples of charts of peak flow recordings and respiratory symptom scores for three children taking part in the study. NEW VIRUSES Bocavirus Metapneumovirus Coronavirus NL63 HKU1 [SARS-CoV] [MERS-CoV] Parechovirus 1995 by British Medical Journal Publishing Group Johnston S L et al. BMJ 1995;310:
12 Virus identifications Child asthma admissions Seasonal incidence of viruses in cohort, and child asthma admissions in Wessex Virus identifications in cohort Correlation = 0.67, p<0.001 Asthma admissions in Wessex Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Month Johnston SL, Pattemore PK, et al.am J Respir Crit Care Med. 1996
13 Articles 140 Publications: Virus AND {asthma OR wheeze} Virus AND [asthma OR wheeze] Date Johnston, Pattemore et al BMJ citations, currently ~60 citations/year
14 % of wheezy episodes posi ve for virus Viruses by RT-PCR in wheezy episodes 100% any virus 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% infancy 0-1 yr 0-1 yr <2 yrs <2 yrs <3 yr >2 yrs >2 yrs 5-7 yrs 2-16 yrs >3 yrs 3m-16 yrs 5-15 yrs 3 yrs 3m-15 yrs 0-6 yrs 2-17 yrs adults adults Infants Children Adults
15 % of wheezy episodes posi ve for virus Viruses by RT-PCR in wheezy episodes any virus rhinovirus 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% infancy 0-1 yr 0-1 yr <2 yrs <2 yrs <3 yr >2 yrs >2 yrs 5-7 yrs 2-16 yrs >3 yrs 3m-16 yrs 5-15 yrs 3 yrs 3m-15 yrs 0-6 yrs 2-17 yrs adults adults Infants Children Adults
16 % of wheezy episodes posi ve for virus Viruses by RT-PCR in wheezy episodes 100% 90% any virus rhinovirus RSV 80% 70% 60% 50% 40% 30% 20% 10% 0% infancy 0-1 yr 0-1 yr <2 yrs <2 yrs <3 yr >2 yrs >2 yrs 5-7 yrs 2-16 yrs >3 yrs 3m-16 yrs 5-15 yrs 3 yrs 3m-15 yrs 0-6 yrs 2-17 yrs adults adults Infants Children Adults
17 Genomic structure (ssrna+) of Human Rhinoviruses Low temperature preference? Detected on 40% cases hands; 6% of home objects Survives up to 2h on human skin Nasopharynx first but can infect all resp cells including alveolar and interstitial Minimal epithelial destruction; disrupts tight junctions Minimal humoral cross-reactivity, but T-cell crossreactivity potentiates higher cytokine response IL-8 activation is associated with worse symptoms, naproxen with less Asymptomatic in 12-32% Jacobs SE et al. Human rhinoviruses. Clin Microbiol Rev. 2013;26(1):
18 Classification of Human Rhinoviruses Family Picornaviridae Genus Enterovirus Genotypic Species: HRV A (74 serotypes) HRV B (25 serotypes) 12 bind LDL-receptor 62 bind ICAM-1 receptor all bind ICAM-1 receptor Minor Group Major Group HRV C (50 serotypes) receptor unknown
19
20 Kolatkar et al. The EMBO journal. 1999;18(22):
21 Epithelial cytokine responses to HRV Jacobs SE et al. Human rhinoviruses. Clin Microbiol Rev. 2013;26(1):
22 A potential role in airway remodelling Saraya et al. Frontiers in Microbiology, 2014;5: 226
23 HRV promotion of bacterial infection Jacobs SE et al. Human rhinoviruses. Clin Microbiol Rev. 2013;26(1):
24
25 HRV-C and ED acute asthma in Perth Bizzintino et al. Eur Respir J Apr 30;37(5):
26 DO VIRUSES CAUSE ASTHMA?
27 The Tucson Study: Martinez et al 1980 Birth cohort = children tested for viruses 207 children with RSV+ve LRTI in first three years of life, Outcome: At 13 years, adjusted odds ratios for: Infrequent wheeze( 3/yr) Frequent (>3/yr) wheeze Stein et al. Lancet 1999; 354: 541.
28 The Swedish Study: Sigurs et al.1989 Design: Index group: 47 children aged <1 year hospitalised with RSV LRTI Dec Apr 1990 Controls: 93 age- and gender-matched children at same centres Diagnosis of bronchiolitis was originally based on criteria published by Court*, but was also consistent with other later published criteria *Court, 1973: Acute bronchiolitis: Illness mainly affecting infants, especially in the first 6 months of life. Rapid respiration, dyspnoea, wheezing, chest recession, cough, rhonchi and rales are very frequent. Visible distension of the chest and increased pulmonary translucency on the chest radiograph are frequent and of high diagnostic significance. Upper respiratory features, especially nasal discharge and a red pharynx are frequent.fever is very frequent, but high fever uncommon. Court SD. The definition of acute respiratory illnesses in children. Postgrad Med J. 1973;49:
29 RSV Bronchiolitis and later asthma Sigurs N et al. Thorax. 2010;65: Proportion With Asthma At 18 yrs 10/18 3/26
30 Sigurs N et al. Thorax. 2010; 65:
31 The Finnish Study: Hyvärinen et al Children hospitalised for wheeze in first 2 years of life Asthma at 11 yrs defined by continuous asthma meds, or recurrent wheeze/cough + positive exercise challenge Virus identified during early hospitalisation Adjusted OR for asthma vs. no asthma at 11 yr RSV 0.41 ( ) 5-fold Rhinovirus 1.41 ( ) 10-fold Fold risk over background asthma prevalence Hyvärinen et al Pediatr Pulmonol 40:
32 Odds Ratio for classification The Perth study: Kusel et al HRV Wheezy LRI 2 RSV Wheezy LRI 1 RSV Nonwheezy LRI HRV Nonwheezy LRI RSV RSV nonwheezy Wheezy LRI HRV Wheezy LRI HRV nonwheezy LRI 0.5 Transient wheeze Late-onset wheeze Persistent wheeze Classification at 5 years old Current wheeze Current asthma Kusel J Allergy Clin Immunol 2007; 119:
33 Perth study: the effect of early sensitisation Predictors of current wheeze at 5 years in relation to time of atopic sensitisation Kusel J Allergy Clin Immunol 2007; 119:
34 The Wisconsin (COAST) Study: Lemanske et al.1998 Percentage Of Children Wheezing in 3 rd Year whz- whz+ RSV Infant viruses +/-wheeze Lemanske et al. J Allergy Clin Immunol. 2004;116(3):571 7.
35 The Wisconsin (COAST) Study: Lemanske et al.1998 Jackson et al. Am J Respir Crit Care Med. 2008;178(7):
36 Asthma Prevalence at 6 yr The Wisconsin (COAST) Study: Lemanske et al Wheezing illness in 1 st year no HRV wheezing HRV wheezing No Yes Aeroallergen sensitisation in 1 st year Jackson et al. Am J Respir Crit Care Med. 2008;178(7):
37 IFN-γ responses in infant wheeze Infant wheeze risk doubles if no IFN-γ response detectable at birth Gern et al. J Allergy Clin Immunol. 2006;117:72-78.
38 IFN-γ responses in adult asthma IFN-γ response of bronchial cells to experimental HRV infection in normal and asthmatic subjects bronchial cell IFN-γ response to RV16 and FEV1 fall in same subjects challenged with RV16 Contoli et al. Nat Med Aug 31;12(9):
39 Asthma prevalence at 6y and IL-13 genotype in Dutch children hospitalised with RSV LRTI in infancy Ermers et al. Journal of Allergy and Clinical Immunology May;119(5):
40 The Revenge of the Microbes Nasopharyngeal colonisation with Strep pneumoniae, H. influenzae and/or M.catarrhalis at 1m old and later wheeze Strep pneumoniae & RV found in weekly winter samples and risk of exacerbations Bisgaard et al. NEJM. 2007;357(15): Kloepfer KM et al. JACI. 2014;133(5):1301-7
41 Model proposed by Fernando Martinez Allergy genes High microbial burden Innate immunity genes No microbial burden Th2 bias High IFN Low IFN Viral infections Late High-allergen-dose atopy Seasonal allergy Early Low-allergen-dose atopy Atopic wheezing Early life wheezing Persistent Low IFN Non-atopic wheezing Is this the basic instrument on which other asthma risk/protection factors play?
42 Treatments & Prevention for Rhinovirus Treatments Capsid-binding Pleconaril phase 2 study (common cold and asthma) awaited Vapendavir phase 2 study (common cold and asthma) awaited Nasal α-2 interferon limited effects, side effects Echinacea insufficient data/evidence Zinc supplementation modest reduction in symptoms Prevention Social distancing and masks + Hand hygiene ++ Jefferson et al. Cochrane database of systematic reviews (7). Interferons, echinacea, vitamin C -- Probiotics + Hao et al.cochrane database of systematic reviews (Online) Dec 31;(9)
43 Summary: Viruses & asthma Viruses have been identified in up to 95% of wheezing episodes / asthma exacerbations, but at low rates at other times Although all respiratory viruses have been identified, Human Rhinovirus (HRV) predominates in most studies in childhood and adults, and some studies in infants. HRV-C was the most common genotype associated with asthma attacks in Perth and was associated with more severe asthma than other HRVs Severe HRV +/- RSV infections with wheeze in infancy are associated with an increased risk of wheezing and asthma in childhood. The risk is especially in children with early atopic sensitisation, suggesting that these children are already set up for more severe infections with wheezing in infancy. Markers of innate immunity are characteristically low in infancy in wheezy infants with HRV or RSV. Innate immunity, severe wheezy infections, and atopy genes seem to determine later wheezing phenotype. Other factors, such as breast feeding, may act via these pathways. There is no clear treatment for rhinovirus at this point but common sense preventive measures are appropriate Southern Alps, near Arthur s Pass
44 Palivizumab in premature neonates and risk of recurrent wheeze to 2-5 yrs of age Simoes, E. A., et al. J Allergy Clin Immunol; (2):
45 IL-13 & IFN-γ responses by wheeze IL-13 responses by wheeze & virus IFN-γ response by FEV1 after HRV infection Gern et al. J Allergy Clin Immunol. 2006;117: Contoli et al. Nat Med Aug 31;12(9):
Potential public health impact of RSV vaccines. R. Karron December 2016
Potential public health impact of RSV vaccines R. Karron December 2016 1. RSV is The leading cause of hospitalization in infants and in many high-income countries; >2 million medical visits annually in
More informationThe Link Between Viruses and Asthma
The Link Between Viruses and Asthma CATHERINE KIER, MD Professor of Clinical Pediatrics Division Chief, Pediatric Pulmonary, and Cystic Fibrosis Center Director, Pediatric Sleep Disorders Center SUNY Stony
More informationRisk Factors for Recurrent Early Wheezing in Childhood: Viral Infections
Risk Factors for Recurrent Early Wheezing in Childhood: Viral Infections Robert F. Lemanske, Jr., M.D. Professor of Pediatrics and Medicine University of Wisconsin Madison, WI Jackson & Lemanske, Immunology
More informationManagement of wheeze in pre-school children. Prof Colin Robertson, Respiratory Medicine, Royal Children s Hospital, Melbourne
Management of wheeze in pre-school children Prof Colin Robertson, Respiratory Medicine, Royal Children s Hospital, Melbourne General Practitioner encounters for asthma Asthma in Australia, 2003 Emergency
More information1/30/2016 RESPIRATORY INFECTIONS AND ASTHMA NO DISCLOSURES NO FINANCIAL INTEREST INFORMATION OBTAINED JACI AJRCCM
RESPIRATORY INFECTIONS AND ASTHMA NO DISCLOSURES NO FINANCIAL INTEREST INFORMATION OBTAINED JACI AJRCCM 1 2 year old male HISTORY -Daycare since 9 months of age -Recurrent symptoms since 10 months of age:
More informationPediatric Asthma. Fernando D. Mar,nez, M.D. Asthma and Airways Disease Research Center The University of Arizona
Pediatric Asthma Fernando D. Mar,nez, M.D. Asthma and Airways Disease Research Center The University of Arizona Disclosure Grant from Johnson and Johnson to study use of Amish dust to prevent asthma Advisor
More informationUniversity of Groningen. Exercise induced bronchoconstriction in childhood asthma van Leeuwen, Janneke
University of Groningen Exercise induced bronchoconstriction in childhood asthma van Leeuwen, Janneke IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to
More informationVaccine Development for Respiratory Viruses in Children. James E. Gern MD Professor of Pediatrics and Medicine University of Wisconsin Madison USA
Vaccine Development for Respiratory Viruses in Children James E. Gern MD Professor of Pediatrics and Medicine University of Wisconsin Madison USA Speaker Disclosure In accordance with the policy of the
More informationERJ Express. Published on September 20, 2011 as doi: /
ERJ Express. Published on September 20, 2011 as doi: 10.1183/09031936.00193310 Febrile respiratory illnesses in infancy & atopy are risk factors for persistent asthma & wheeze. Authors List Merci M H Kusel
More informationAppendix E1. Epidemiology
Appendix E1 Epidemiology Viruses are the most frequent cause of human infectious diseases and are responsible for a spectrum of illnesses ranging from trivial colds to fatal immunoimpairment caused by
More informationMalik Sallam. Ola AL-juneidi. Ammar Ramadan. 0 P a g e
1 Malik Sallam Ola AL-juneidi Ammar Ramadan 0 P a g e Today's lecture will be about viral upper respiratory tract infections. Those include: common cold, sinusitis, otitis, etc. Infections in the upper
More informationAcute viral infections are a major cause of. Serial viral infections in infants with recurrent respiratory illnesses
Eur Respir J 2008; 32: 314 320 DOI: 10.1183/09031936.00161907 CopyrightßERS Journals Ltd 2008 Serial viral infections in infants with recurrent respiratory illnesses T. Jartti*, W-M. Lee*, T. Pappas*,
More informationRespiratory System Virology
Respiratory System Virology Common Cold: Rhinitis. A benign self limited syndrome caused by several families of viruses. The most frequent acute illness in industrialized world. Mild URT illness involving:
More informationIdentifying Biologic Targets to Attenuate or Eliminate Asthma Exacerbations
Identifying Biologic Targets to Attenuate or Eliminate Exacerbations exacerbations are a major cause of disease morbidity and costs. For both children and adults, viral respiratory infections are the major
More informationSneezing leads to wheezing: microorganisms important in asthma
Sneezing leads to wheezing: microorganisms important in asthma In Focus Christiana Willenborg Virology Division SEALS Microbiology Prince of Wales Hospital Randwick, NSW 2031, Australia Tel: +61 2 9382
More informationEARN 3 FREE CPD POINTS
EARN 3 FREE CPD POINTS asthma and allergy Leader in digital CPD for Southern African healthcare professionals Asthma and allergy: Influence of EARLY LIFE RISK EXPOSURE Professor Peter Sly Director: World
More informationNew viruses causing respiratory tract infections. Eric C.J. Claas
New viruses causing respiratory tract infections Eric C.J. Claas (Re) emerging infectious diseases: what is new? Morens et al. Nature 2004 Virus discovery New molecular methods result in frequent detection
More informationOutcome, classification and management of wheezing in preschool children Paul L.P. Brand
Outcome, classification and management of wheezing in preschool children Paul L.P. Brand Princess Amalia Children s Clinic Isala klinieken, Zwolle the Netherlands p.l.p.brand@isala.nl Valle de la Luna,
More informationAssessing wheeze in pre-school children
Assessing wheeze in pre-school children 8 Wheeze in children aged less than five years has many potential causes. Often it is regarded as the first sign of asthma, however, a substantial proportion of
More informationEvolution of asthma from childhood. Carlos Nunes Center of Allergy and Immunology of Algarve, PT
Evolution of asthma from childhood Carlos Nunes Center of Allergy and Immunology of Algarve, PT allergy@mail.telepac.pt Questionnaire data Symptoms occurring once or several times at follow-up (wheeze,
More informationHealth professionals. 8Asthma. and Wheezing in the First Years of Life. A guide for health professionals
Health professionals 8Asthma and Wheezing in the First Years of Life A guide for health professionals Asthma and Wheezing in the First Years of Life An information paper for health professionals The aim
More informationA viral infection is commonly implicated as the
The Contribution of Respiratory Viruses to Severe Exacerbations of Asthma in Adults* Mehrgan Sokhandan, MD, FCCP; E. Regis McFadden, Jr., MD; Yung T. Huang, PhD; and Mary B. Mazanec, MD Viral infections
More informationUnderstanding Early Wheezing in the Development of Airflow Limitation in Children
Understanding Early Wheezing in the Development of Airflow Limitation in Children Bradley Chipps, MD Capital Allergy & Respiratory Disease Center Sacramento, CA Western Society of Allergy, Asthma and Immunology
More informationRecurrent Wheezing in Preschool Children. William Sheehan, MD Associate Professor of Pediatrics Division of Allergy and Immunology
Recurrent Wheezing in Preschool Children William Sheehan, MD Associate Professor of Pediatrics Division of Allergy and Immunology Disclosure I have nothing to disclose related to this talk. Background
More informationLife-long asthma and its relationship to COPD. Stephen T Holgate School of Medicine University of Southampton
Life-long asthma and its relationship to COPD Stephen T Holgate School of Medicine University of Southampton Definitions COPD is a preventable and treatable disease with some significant extrapulmonary
More informationWhat is the best way to treat recurrent wheeze in pre-school children?
What is the best way to treat recurrent wheeze in pre-school children? Miles Weinberger MD Professor of Pediatrics www.uihealthcare.com/allerpulm Lower airway obstruction Asthma vs bronchiolitis? Both
More informationAsthma in Pediatric Patients. DanThuy Dao, D.O., FAAP. Disclosures. None
Asthma in Pediatric Patients DanThuy Dao, D.O., FAAP Disclosures None Objectives 1. Discuss the evaluation and management of asthma in a pediatric patient 2. Accurately assess asthma severity and level
More informationViral Infection. Pulmonary Infections with Respiratory Viruses. Wallace T. Miller, Jr., MD. Objectives: Viral Structure: Significance:
Viral Infection Wallace T. Miller, Jr., MD Pulmonary Infections with Respiratory Viruses Wallace T. Miller, Jr. MD Associate Professor of Radiology and Pulmonary and Critical Care Medicine University of
More informationRespiratory virus associated communityacquired pneumonia in Western Australian Children: case-control study
Respiratory virus associated communityacquired pneumonia in Western Australian Children: case-control study Mejbah Bhuiyan PhD Candidate, School of Paediatrics and Child Health The University of Western
More informationViral infections in airway remodeling
Viral infections in airway remodeling Nikos Papadopoulos As. Proffesor,Head, Allergy Dpt, 2 nd Pediatric Clinic, University of Athens Overview Acute events may have long term consequences Remodeling appears
More informationEmerging Respiratory Infections NZ Amanda McNaughton Respiratory Physician CCDHB Wellington
Emerging Respiratory Infections NZ 2015 Amanda McNaughton Respiratory Physician CCDHB Wellington Respiratory Infection: overview Influenza virus Clinical picture Emerging infection New Zealand Influenza
More informationبسم هللا الرحمن الرحيم
- 1 - - - 1 P a g e بسم هللا الرحمن الرحيم This sheet was made from record section 1 all information are included - Introduction Our respiratory tract is divided anatomically to upper (URT),middle and
More informationViral infection in wheezy bronchitis and asthma
Archives of Disease in Childhood, 1976, 51, 707. Viral infection in wheezy bronchitis and asthma in children I. MITCHELL, H. INGLIS, and H. SIMPSON From the Royal Hospital for Sick Children and City Hospital,
More informationCommunity and Hospital Surveillance
6SSN 2324-497 Community and Hospital Surveillance ILI, SARI, Influenza and Respiratory Pathogens 217 Influenza Season, Week 3, ending 3 July 217 SUMMARY Influenza-like illness (ILI) consultation rates
More informationBronchiolitis, an airway disease primary
Eur Respir J 2012; 39: 396 402 DOI: 10.1183/09031936.00188210 CopyrightßERS 2012 Rhinovirus bronchiolitis and recurrent wheezing: 1-year follow-up F. Midulla*, A. Pierangeli #, G. Cangiano*, E. Bonci*,
More informationTis the Season Respiratory that is
Tis the Season Respiratory that is Jason LeBlanc Director Virology, Immunology, Molecular Microbiology, NHSA Central Objectives Understand the etiology and epidemiology of viral respiratory tract infection
More informationTREAMENT OF RECURRENT VIRUS-INDUCED WHEEZING IN YOUNG CHILDREN. Dr Lại Lê Hưng Respiratory Department
TREAMENT OF RECURRENT VIRUS-INDUCED WHEEZING IN YOUNG CHILDREN Dr Lại Lê Hưng Respiratory Department Literature review current through: Feb 2013. This topic last updated: Aug 14, 2012 INTRODUCTION Wheezing
More informationVIRUSES ASSOCIATED WITH ACUTE EXACERBATION OF BRONCHIAL ASTHMA AMONG CHILDREN IN UNIVERSITY MALAYA MEDICAL CENTRE
ORIGINAL ARTICLE VIRUSES ASSOCIATED WITH ACUTE EXACERBATION OF BRONCHIAL ASTHMA AMONG CHILDREN IN UNIVERSITY MALAYA MEDICAL CENTRE Rakhee Yadav 1 1. Hospital Tengku Ampuan Rahimah, Jalan Langat, 41200,
More information8 Public Health Wales CDSC Weekly Influenza Surveillance Report Wednesday 21 August 2013 (covering week )
8 Public Health Wales CDSC Weekly Influenza Surveillance Report Wednesday 21 August 213 (covering week 33 213) Current level of activity: Low Trend: Stable compared to last week News: Update Middle East
More informationHuman rhinoviruses and Influenza
Human rhinoviruses and Influenza 3 rd Annual ANISE Meeting at Crowne Plaza-Nairobi Clayton Onyango, PhD KEMRI-Wellcome Trust Programme, Kilifi Paediatric IP respiratory virus surveillance at KDH 60 Multiplex
More informationViral Threat on Respiratory Failure
Viral Threat on Respiratory Failure Younsuck Koh, MD, PhD, FCCM Department of Pulmonary and Critical Care Medicine Asan Medical Center University of Ulsan College of Medicine Seoul, Korea No Conflict of
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Edwards KM, Zhu Y, Griffin MR, et al. Burden of human metapneumovirus
More informationSniffs and Sneezes can Spread Diseases: Year- Round Protection. Jim Gauthier, MLT, CIC Senior Clinical Advisor, Infection Prevention
Sniffs and Sneezes can Spread Diseases: Year- Round Protection Jim Gauthier, MLT, CIC Senior Clinical Advisor, Infection Prevention Objectives Look at various viral respiratory illnesses Discuss year-round
More informationDiscover the connection
Jill is about to have asthma symptoms and she won t know why. Timothy grass ASTHMA Dog dander House dust mites Underlying allergies affect asthma Discover the connection Specific IgE blood testing helps
More informationSeasonality of influenza activity in Hong Kong and its association with meteorological variations
Seasonality of influenza activity in Hong Kong and its association with meteorological variations Prof. Paul Chan Department of Microbiology The Chinese University of Hong Kong Mr. HY Mok Senior Scientific
More informationPneumococcal Vaccine in Children: current situation
Pneumococcal Vaccine in Children: current situation LAU Yu Lung Chair Professor of Paediatrics Doris Zimmern Professor in Community Child Health LKS Faculty of Medicine, The University of Hong Kong Chairman
More informationSOP Objective To provide Healthcare Workers (HCWs) with details of the precautions necessary to minimise the risk of RSV cross-infection.
Page 1 of 11 SOP Objective To provide Healthcare Workers (HCWs) with details of the precautions necessary to minimise the risk of RSV cross-infection. This SOP applies to all staff employed by NHS Greater
More informationEarly-life respiratory viral infections, atopic sensitization, and risk of subsequent development of persistent asthma
Early-life respiratory viral infections, atopic sensitization, and risk of subsequent development of persistent asthma Merci M. H. Kusel, MBBS, PhD, a Nicholas H. de Klerk, MSc, PhD, a Tatiana Kebadze,
More informationAssociation between human rhinovirus C and severity of acute asthma in children
Eur Respir J 2011; 37: 1037 1042 DOI: 10.1183/09031936.00092410 CopyrightßERS 2011 Association between human rhinovirus C and severity of acute asthma in children J. Bizzintino*,#,##, W-M. Lee ",##, I.A.
More informationDistinction and Overlap. Allergy Dpt, 2 nd Pediatric Clinic, University of Athens
Asthma Phenotypes: Distinction and Overlap Nikos Papadopoulos Allergy Dpt, 2 nd Pediatric Clinic, University of Athens Asthma as a syndrome From the Iliad to ADAM 33 and back again Bronchoconstriction,
More informationBronchiolitis is the most common lower
Eur Respir J 2012; 39: 76 80 DOI: 10.1183/09031936.00040211 CopyrightßERS 2012 Preschool asthma after bronchiolitis in infancy P. Koponen*, M. Helminen*, M. Paassilta #, T. Luukkaala " and M. Korppi* ABSTRACT:
More informationDurham Region Influenza Bulletin: 2017/18 Influenza Season
Durham Region Influenza Bulletin: 2017/18 Influenza Season Surveillance Week 21 (May 20, 2018 to May 26, 2018) Table 1: Assessment of influenza activity in Durham Region Measure Laboratory confirmed cases
More informationRespiratory Syncytial Virus (RSV) in Older Adults: A Hidden Annual Epidemic. Webinar Agenda
Respiratory Syncytial Virus (RSV) in Older Adults: A Hidden Annual Epidemic Wednesday, November 2, 2016 12:00 PM ET Webinar Agenda Agenda Welcome and Introductions William Schaffner, MD, NFID Medical Director
More informationPathology of Asthma Epidemiology
Asthma A Presentation on Asthma Management and Prevention What Is Asthma? A chronic disease of the airways that may cause Wheezing Breathlessness Chest tightness Nighttime or early morning coughing Pathology
More informationAllergy and Immunology Review Corner: Chapter 75 of Middleton s Allergy Principles and Practice, 7 th Edition, edited by N. Franklin Adkinson, et al.
Allergy and Immunology Review Corner: Chapter 75 of Middleton s Allergy Principles and Practice, 7 th Edition, edited by N. Franklin Adkinson, et al. Chapter 75: Approach to Infants and Children with Asthma
More informationBronchiolitis Update. Key reviewer: Dr Philip Pattemore, Associate Professor of Paediatrics, University of Otago, Christchurch.
www.bpac.org.nz keyword: bronchiolitis Bronchiolitis Update Key reviewer: Dr Philip Pattemore, Associate Professor of Paediatrics, University of Otago, Christchurch Key Points: Bronchiolitis is the most
More informationWHEEZING IN INFANCY: IS IT ASTHMA?
WHEEZING IN INFANCY: IS IT ASTHMA? Jittlada Deerojanawong Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Wheezing is common symptoms throughout infancy and childhood
More informationInfluenza A (H1N1)pdm09 in Minnesota Epidemiology
Influenza A (H1N1)pdm09 in Minnesota Epidemiology Infectious Disease Epidemiology, Prevention and Control Division PO Box 64975 St. Paul, MN 55164-0975 Number of Influenza Hospitalizations by Influenza
More informationPolymicrobial respiratory tract infections in a hospital-based pediatric population, with particular emphasis on the role of human rhinoviruses
University of Iowa Iowa Research Online Theses and Dissertations Fall 2010 Polymicrobial respiratory tract infections in a hospital-based pediatric population, with particular emphasis on the role of human
More informationObjectives. The Present and Future of Asthma: Birth Cohorts & Public Health Devon A. Greene, MD, MPH June 11, What is Asthma.
The Present and Future of : Birth Cohorts & Public Health Devon A. Greene, MD, MPH June 11, 2014 Objectives Become familiar with the evidence from available long-term studies on the natural history of
More informationPulmonary Perspective
Pulmonary Perspective Bronchiolitis to Asthma A Review and Call for Studies of Gene Virus Interactions in Asthma Causation Anne Marie Singh, Paul E. Moore, James E. Gern, Robert F. Lemanske, Jr., and Tina
More informationPublic Health Wales CDSC Weekly Influenza Surveillance Report Wednesday 21 st January 2015 (covering week )
The The Influenza B in certain countries8 Public Health Wales CDSC Weekly Influenza Surveillance Report Wednesday 21 st January 215 (covering week 3 215) Current level of activity: Low Trend: Decreased
More informationEffects of omalizumab on RV infections, illnesses, and exacerbations of asthma. James Gern, MD Ann Esquivel, MD University of Wisconsin, Madison
Effects of omalizumab on RV infections, illnesses, and exacerbations of asthma James Gern, MD Ann Esquivel, MD University of Wisconsin, Madison Background: Omalizumab Mechanism of Action Primary Mechanism
More informationPerspectives on vaccination against respiratory syncytial virus
Perspectives on vaccination against respiratory syncytial virus What makes the development of RSV vaccines challenging? Oliver Wicht PhD, Projectleader MD-RSV antibodies RIVM, Centrum infektieziektenbestrijding
More informationViral-Induced Asthma:
Viral-Induced : Sorting through the Studies Malcolm R. Sears, MB, FRACP, FRCPC Presented at the Respirology Update Continuing Education Program, January 2005 Viral-associated wheezing is common and not
More informationPNEUMONIA IN CHILDREN. IAP UG Teaching slides
PNEUMONIA IN CHILDREN 1 INTRODUCTION 156 million new episodes / yr. worldwide 151 million episodes developing world 95% in developing countries 19% of all deaths in children
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Bisgaard H, Hermansen MN, Buchvald F, et al. Childhood asthma
More informationExhaled Nitric Oxide: An Adjunctive Tool in the Diagnosis and Management of Asthma
Exhaled Nitric Oxide: An Adjunctive Tool in the Diagnosis and Management of Asthma Jason Debley, MD, MPH Assistant Professor, Pediatrics Division of Pulmonary Medicine University of Washington School of
More informationRespiratory Multiplex Array. Rapid, simultaneous detection of 22 bacterial and viral pathogens of the upper and lower respiratory tract
Rapid, simultaneous detection of 22 bacterial and viral pathogens of the upper and lower respiratory tract Rapid, simultaneous detection of 22 bacterial and viral pathogens within the upper and lower respiratory
More informationPaediatric Food Allergy. Introduction to the Causes and Management
Paediatric Food Allergy Introduction to the Causes and Management Allergic Reactions in Children Prevalence of atopic disorders in urbanized societies has increased significantly over the past several
More informationRole of multiplex PCR in the diagnostics of respiratory viruses. PIGS course November 25 th -26 th 2016 Julia Bielicki AND Sandra Asner
Role of multiplex PCR in the diagnostics of respiratory viruses PIGS course November 25 th -26 th 2016 Julia Bielicki AND Sandra Asner Overview Introduction Molecular assays available (including POC) PROs
More informationPredicting, Preventing and Managing Asthma Exacerbations. Heather Zar Department of Paediatrics & Child Health University of Cape Town South Africa
Predicting, Preventing and Managing Asthma Exacerbations Heather Zar Department of Paediatrics & Child Health University of Cape Town South Africa Asthma exacerbations Predicting exacerbation recognising
More informationAvg PM10. Avg Low Temp
Geography 532 Geography of Environmental Health Dr. Paul Marr Name: Ex 16- Seasonality, Time Delay, and Disease (10 pts) Below are asthma cases per month for the years 1992-1994. The table also includes
More informationWheeze. Respiratory Tract Symptoms. Prof RJ Green Department of Paediatrics. Cough. Wheeze/noisy breathing. Acute. Tight chest. Shortness of breath
Wheeze Prof RJ Green Department of Paediatrics Respiratory Tract Symptoms Cough Tight chest Wheeze/noisy breathing Shortness of breath Acute Chronic Respiratory rate Most important sign of respiratory
More informationBOVINE RESPIRATORY DISEASE COMPLEX น.สพ.ฐปณ ฐ สงคส ภา สถาบ นส ขภาพส ตว แห งชาต
BOVINE RESPIRATORY DISEASE COMPLEX น.สพ.ฐปณ ฐ สงคส ภา สถาบ นส ขภาพส ตว แห งชาต The Most Common Causes of Death Source: Department of Agriculture s Laboratories Quarterly Surveillance Report, 2015(IRELAND)
More informationSARI, Influenza and Respiratory Pathogens
ISSN 2324-3589 Hospital Surveillance SARI, Influenza and Respiratory Pathogens Monthly Report, November 15 SUMMARY During weeks 45-48 (2 November 29 November 15), influenza activity decreased in hospital
More informationInfections in children with asthma
International Journal of Immunology 2014; 2(1): 1-5 Published online January 30, 2014 (http://www.sciencepublishinggroup.com/j/iji) doi: 10.11648/j.iji.20140201.11 Infections in children with asthma Abdullah
More informationSARI, Influenza and Respiratory Pathogens
ISSN 2324-3589 Hospital Surveillance SARI, Influenza and Respiratory Pathogens Monthly Report, April 15 SUMMARY During weeks 14-17 ( March 26 April 15), influenza activity remained low in hospital surveillance
More informationInfluenza Season and EV-D68 Update. Johnathan Ledbetter, MPH
2014-2015 Influenza Season and EV-D68 Update Johnathan Ledbetter, MPH 2014-2015 Influenza Season Influenza Reporting Individual cases are not reportable in the state of Texas Situations where influenza
More informationLong-term studies of the natural history of asthma in childhood
Clinical reviews in allergy and immunology Series editors: Donald Y. M. Leung, MD, PhD, and Dennis K. Ledford, MD Long-term studies of the natural history of asthma in childhood Hans Bisgaard, MD, DMSc,
More informationVinita Rane Supervisor: Maryza Graham
Old bug, new tricks Vinita Rane Supervisor: Maryza Graham 6 week old female Initial presentation (outside Monash): Unwell since 3/52 old Cough, associated with cyanotic episodes Coryza Lethargy Vomiting
More informationAsthma and COPD in older people lumping or splitting? Christine Jenkins Concord Hospital Woolcock Institute of Medical Research
Asthma and COPD in older people lumping or splitting? Christine Jenkins Concord Hospital Woolcock Institute of Medical Research Concord Hospital Woolcock Institute of Medical Research Joe has asthma What
More informationManeig de les infeccions respiratòries per virus emergents. Antonella Francesca Simonetti Servicio de Enfermedades Infecciosas
Maneig de les infeccions respiratòries per virus emergents Antonella Francesca Simonetti Servicio de Enfermedades Infecciosas Virus respiratorios emergentes Enterovirus D68 MERS-CoV Enterovirus D68 EV
More informationThe Burden and Long-term Respiratory Morbidity Associated with Respiratory Syncytial Virus Infection in Early Childhood
Infect Dis Ther (2017) 6:173 197 DOI 10.1007/s40121-017-0151-4 REVIEW The Burden and Long-term Respiratory Morbidity Associated with Respiratory Syncytial Virus Infection in Early Childhood Brigitte Fauroux.
More informationEarly Administration of Azithromycin and Prevention of Severe Lower Respiratory Tract Illnesses in Preschool Children With a History of Such Illnesses
Early Administration of Azithromycin and Prevention of Severe Lower Respiratory Tract Illnesses in Preschool Children With a History of Such Illnesses M I R E N G U E N E C H E A - S O L A, M. D. U C S
More informationREPLICATION DATA SET FOR:
REPLICATION DATA SET FOR: Cohen, S., Janicki-Deverts, D., Turner, R.B., & Doyle, W.J. (in press). Does hugging provide stress-buffering social support? A study of susceptibility to upper respiratory infection
More informationRESPIRE INSPIRE FOCUS ON... SUMMER RESPIRATORY INFECTIONS. Polyvalent Mechanical Bacterial Lysate. June 2017
FOCUS ON... SUMMER RESPIRATORY INFECTIONS June 17 Polyvalent Mechanical Bacterial Lysate Risks of respiratory tract infections are not limited to wintertime Seasonality is a well-known phenomenon in public
More informationpneumonia 2015;6:48 56
pneumonia 2015 Aug 21;6:48 56 pneumonia Brief Report Anne B Chang a,b, Heidi Smith-Vaughan a,c, Theo P Sloots f, Patricia C Valery a, David Whiley f, Jemima Beissbarth a, Paul J Torzillo d,e a Menzies
More informationPaediatric Pulmonology Report 2014
Paediatric Pulmonology Report 2014 STATS Out-Patients 1864 visits ASTHMA BRONCHIE CYSTIC FIBROSIS JANUARY 72 12 16 FEBRUARY 118 37 20 MARCH 139 36 16 APRIL 89 26 24 MAY 122 31 15 JUNE 114 25 10 JULY 155
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE 1 Guideline title SCOPE Bronchiolitis: diagnosis and management of bronchiolitis in children. 1.1 Short title Bronchiolitis in children 2 The remit The
More informationTips on managing asthma in children
Tips on managing asthma in children Dr Ranjan Suri Consultant in Respiratory Paediatrics Bupa Cromwell Hospital Clinics: Friday (pm) Asthma in Children Making the diagnosis Patterns of childhood asthma
More informationSUPPLEMENTARY ONLINE MATERIAL SEARCH STRATEGY
SUPPLEMENTARY ONLINE MATERIAL SEARCH STRATEGY Medline (Ovid) Studies that describe epidemiology in severe cases. 1. exp respiratory syncytial viruses/ or respiratory syncytial virus, human/ 2. Respirovirus
More informationCOPD, Asthma, Or Something In Between? Sharon R. Rosenberg Assistant Professor of Medicine Northwestern University December 4, 2013
COPD, Asthma, Or Something In Between? Sharon R. Rosenberg Assistant Professor of Medicine Northwestern University December 4, 2013 None Disclosures Definitions Asthma Asthma is a chronic inflammatory
More informationManagement of asthma in preschool children with inhaled corticosteroids and leukotriene receptor antagonists Leonard B. Bacharier
Management of asthma in preschool children with inhaled corticosteroids and leukotriene receptor antagonists Leonard B. Bacharier Department of Pediatrics, Division of Allergy and Pulmonary Medicine, Washington
More informationAsthma: a major pediatric health issue Rosalind L Smyth
Asthma: a major pediatric health issue Rosalind L Smyth University of Liverpool, Institute of Child Health, Alder Hey Children s Hospital, Liverpool L12 2AP, UK Corresponding author: Rosalind L Smyth (e-mail:
More informationHuman Coronavirus in the 2014 Winter Season as a Cause of Lower Respiratory Tract Infection
Original Article Yonsei Med J 2017 Jan;58(1):174-179 pissn: 0513-5796 eissn: 1976-2437 Human Coronavirus in the 2014 Winter Season as a Cause of Lower Respiratory Tract Infection Kyu Yeun Kim 1, Song Yi
More informationInfantile respiratory syncytial virus and human rhinovirus infections: respective role in inception and persistence of wheezing
REVIEW RSV AND HRV INFECTION Infantile respiratory syncytial virus and human rhinovirus infections: respective role in inception and persistence of wheezing Giovanni A. Rossi 1 and Andrew A. Colin 2 Affiliations:
More informationIdentifying Respiratory Viral Pathogens
Identifying Respiratory Viral Pathogens Theo Sloots Unit Director Queensland Paediatric Infectious Diseases Laboratory Children s Health Service, Brisbane Queensland Children s Medical Research Institute
More information