Cough In Infancy Research Articles

About whooping cough in infancy

Gottlieb and Mller describe (Jahrb. F. Kinderh. Bd. 100) the 1921 whooping cough epidemic in Heidelberg.

The Editor takes a closer look at some of this month's articles

Clinical & Experimental AllergyVolume 45, Issue 9 p. 1373-1373 Editor's ChoiceFree Access The Editor takes a closer look at some of this month's articles First published: 24 August 2015 https://doi.org/10.1111/cea.12602AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat The gut microbiome: a key to the development of allergic disease? A fascinating story is emerging that a general lack of diversity of the gut microbiome and a reduced presence of those gut commensals which induce a tolerant immune environment is associated with the development of allergic disease in early childhood 1. Moreover, a tolerance inducing gut microbiome is a feature of infants brought up in a farming environment which has been clearly shown to be associated with a greatly reduced risk of developing allergic disease 2. This story is given further support by West and colleagues who have found a relationship between eczema and an infant gut microbiome which contains low levels of tolerance associated gut bacteria such as Ruminococcaceae and Proteobacteria. Reduced amounts of these bacterial types in the gut are in turn associated with enhanced innate immune responses with increased production of inflammatory mediators such as TNF-alpha. This increasingly persuasive explanation for the allergy epidemic is in tune with the idea that probiotics are the solution to childhood allergies, a topic which has long been popular with our authors 3. Christina West Microbiota composition at the phylum level and α-diversity at 1 week, 1 month and 1 year in vaginally delivered infants (n = 7, n = 5, n = 11) and their mothers (n = 11), and Caesarean-delivered infants (n = 7, n = 6, n = 9) and their mothers (n = 8) in pregnancy. [See figure 1a in C. E. West et al. (pp. 1419–1429)]. Harbingers of asthma: infant cough as well as wheeze Both wheeze and cough are characteristic symptoms of asthma. However, while infant wheeze has been exhaustively explored as a marker for the subsequent development of asthma, cough as a sentinel symptom has been relatively ignored. In a novel and deceptively simple paper, Oren et al. have taken advantage of a non-selected birth cohort to determine whether a persistent cough in infancy predicts the later onset of asthma between the ages of 2 and 9. They found a greater than threefold increase in the likelihood of a later diagnosis of asthma in infants who had a persistent cough in the first year of life which was independent of wheeze. The association was particularly strong in those children whose mothers had asthma. It will be interesting to know whether the same heterogeneity is seen in infant coughers as has been demonstrated for infant wheezers. Eyal Oren The prevalence of asthma by cough duration, stratified by the presence of maternal asthma. [See figure 3 in E. Oren et al. (pp. 1439–1446)]. References 1Abrahamsson TR, Jakobsson HE, Andersson AF, Bjorksten B, Engstrand L, Jenmalm MC. Low gut microbiota diversity in early infancy precedes asthma at school age. Clin Exp Allergy 2014; 44: 842– 50. 2Braun-Fahrlander C, von Mutius E. Can farm milk consumption prevent allergic diseases? Clin Exp Allergy 2011; 41: 29– 35. 3Campbell DE. Probiotics and primary prevention of atopic disease: are we closer to a firm evidence base for clinical use? Clin Exp Allergy 2013; 43: 978– 80. Caption to cover illustration: An example of vocal cord dysfunction (Image courtesy of S. J. Fowler). This logo highlights the Editor's choice articles on the cover and the first page of each of the articles. Volume45, Issue9September 2015Pages 1373-1373 ReferencesRelatedInformation

Environmental triggers of nocturnal dry cough in infancy: New insights about chronic domestic exposure to formaldehyde in the PARIS birth cohort

Although formaldehyde is a common indoor pollutant, its impact on respiratory symptoms in childhood remains unclear.The aim of this study was to examine the relation between domestic formaldehyde exposure and occurrence of coughing, one of the most prevalent respiratory symptoms during the first year of life of infants from the PARIS birth cohort involving 3840 healthy full-term babies. The presence of respiratory symptoms, including dry cough at night apart from a cold or chest infection in the past 12 months was reported on a standardized health questionnaire. Formaldehyde exposure was estimated for all infants using a predictive model established from data (both repeated measurements and information about determinants of levels) collected in a random sample of infants from the cohort. An unconditional logistic regression was fitted to study the relation between annual domestic formaldehyde exposure and dry cough at night, adjusting for all potential risk factors/confounders.The prevalence of dry cough at night was 14.9%. Parental history of allergy was found to modify the relation between environmental factors and dry cough. Cockroaches, used mattresses, and family stressor events were associated with dry cough in infants with parental allergy history. Conversely, domestic formaldehyde exposure tended to increase occurrence of dry cough at night only among babies without parental history of allergy (adjusted OR per 10µg/m3 increase in levels, single imputation approach: 1.45, 95% CI: 1.08–1.96, and Bayesian approach: 1.12, 0.91–1.36).This study suggests that the impact of indoor environmental exposure on dry cough at night in infancy is different depending on the presence or not of parental history of allergy.

Viral Etiology of Acute Respiratory Infections With Cough in Infancy

Acute respiratory infections (ARI) are a major cause of morbidity in infancy worldwide, with cough and wheeze being alarming symptoms to parents. We aimed to analyze in detail the viral aetiology of ARI with such symptoms in otherwise healthy infants, including rhinoviruses and recently discovered viruses such as human metapneumovirus (HMPV), coronavirus NL63 and HKU1, and human bocavirus (HBoV). We prospectively followed 197 unselected infants during their first year of life and assessed clinical symptoms by weekly standardized interviews. At the first ARI with cough or wheeze, we analyzed nasal swabs by sensitive individual real time polymerase chain reaction assays targeting 16 different respiratory viruses. All 112 infants who had an ARI had cough, and 39 (35%) had wheeze. One or more respiratory viruses were found in 88 of 112 (79%) cases. Fifteen (17%) dual and 3 (3%) triple infections were recorded. Rhino- (23% of all viruses) and coronaviruses (18%) were most common, followed by parainfluenza viruses (17%), respiratory syncytial virus (RSV) (16%), HMPV (13%), and HBoV (5%). Together rhinoviruses, coronaviruses, HMPV, and HBoV accounted for 60% (65 of 109) of viruses. Although symptom scores and need for general practitioner (GP) consultations were highest in infants infected with RSV, they were similar in infants infected with other viruses. Viral shedding at 3 weeks occurred in 20% of cases. Rhinoviruses, coronaviruses, HMPV, and HBoV are common pathogens associated with respiratory symptoms in otherwise healthy infants. They should be considered in the differential diagnosis of the aetiology of ARI in this age group.

Evidence of Bordetella pertussis infection in adults presenting with persistent cough in a french area with very high whole-cell vaccine coverage.

Although France has had a vaccination program for 40 years, since 1990, an increase in whooping cough cases with parent-infant transmission has been observed. This study prospectively assessed the frequency of Bordetella pertussis infection in adults who consulted general practitioners for a persistent cough without an evident diagnosis. Among 217 patients, 70 (32%) confirmed whooping cough cases were identified. One case was culture positive, 36 were polymerase chain reaction positive, and 40 had increases or decreases of > or =2-fold in anti-pertussis toxin IgG titer between serum samples collected during the acute and convalescent phases. The median duration of cough in confirmed cases was 49 days (range, 13-123 days). Of the patients, 60% reported vaccination, and 33% reported whooping cough in infancy. Pertussis should be considered for diagnosis of acute and chronic cough in adults. Future studies should evaluate the public health interest of booster doses of pertussis vaccine in adults.

Relation of birth weight and childhood respiratory infection to adult lung function and death from chronic obstructive airways disease.

To examine whether birth weight, infant weight, and childhood respiratory infection are associated with adult lung function and death from chronic obstructive airways disease. Follow up study of men born during 1911-30 whose birth weights, weights at 1 year, and childhood illnesses were recorded at the time by health visitors. Hertfordshire, England. 5718 men born in the county during 1911-30 and a subgroup of 825 men born in the county during 1920-30 and still living there. Death from chronic obstructive airways disease, mean forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), and respiratory symptoms. 55 men died of chronic obstructive airways disease. Death rates fell with increasing birth weight and weight at 1 year. Mean FEV1 at age 59 to 70 years, adjusted for height and age, rose by 0.06 litre (95% confidence interval 0.02 to 0.09) with each pound (450 g) increase in birth weight, independently of smoking habit and social class. Bronchitis or pneumonia in infancy was associated with a 0.17 litre (0.02 to 0.32) reduction in adult FEV1 and with an increased odds ratio of wheezing and persistent sputum production in adult life independently of birth weight, smoking habit, and social class. Whooping cough in infancy was associated with a 0.22 litre (0.02 to 0.42) reduction in adult FEV1. Lower birth weight was associated with worse adult lung function. Intrauterine influences which retard fetal weight gain may irrecoverably constrain the growth of the airways. Bronchitis, pneumonia, or whooping cough in infancy further reduced adult lung function. They also retarded infant weight gain. Consistent with this, death from chronic obstructive airways disease in adult life was associated with lower birth weight and weight at 1 year. Promoting lung growth in fetuses and infants and reducing the incidence of lower respiratory tract infection in infancy may reduce the incidence of chronic obstructive airways disease in the next generation.

Respiratory sequelae and lung function after whooping cough in infancy.

The lung function of 31 children, aged 6-13 years, who had whooping cough as infants and 32 control children matched for age, sex, and residence area were compared in a community based cohort study. Family history of obstructive airway disease, smoking habits in the family, atopy, and other background factors examined were similar in the two groups. The ratios of recalled repeated acute respiratory infections did not differ among the groups. Children in the control group were slightly more involved in physical activities. History of obstructive airway disease, findings on chest radiography, and distribution of immunoglobulin concentrations, including IgE, did not differ significantly. Lung function before and after exercise and after inhalation of salbutamol were not different. No impairment of small airways was detected. Our data do not support the hypothesis that whooping cough in itself is a causal factor for later obstructive respiratory disease.

Effect of whooping cough in infancy on subsequent lung function and bronchial reactivity.

Thirty-six children younger than 1 yr of age hospitalized for whooping cough approximately 9 yr previously (cases) were compared with 36 control children of the same age and sex. Subjects were sampled from participants in an earlier large field study of the long-term sequelae of whooping cough. Respiratory symptoms were more common in cases, although the differences were not statistically significant. Cases were significantly more likely either to be atopic or to have a family history of wheezing illness. There were no significant differences between cases and control subjects in lung function indices derived from maximal expiratory flow volume loops or from single-breath nitrogen washout tests or in bronchial reactivity as judged by the histamine challenge PC20. The evidence from both the present and the earlier study indicates that whooping cough is unlikely to be a causal factor in later respiratory illnesses and symptoms and that no deficit in lung function can be detected in later childhood. The disease may, however, occur more frequently or be more easily recognized in children with environmental or constitutional factors that predispose to respiratory morbidity.

Whooping Cough in Infancy

Whooping Cough in Infancy

Whooping Cough in Infancy

Whooping Cough in Infancy