Viral upper respiratory tract infection and otitis media complication in young children

Chonmaitree, Tasnee; Revai, Krystal; Grady, James J.; Clos, Audra; Patel, Janak A.; Nair, Sangeeta; Fan, Jiang; Henrickson, Kelly J.

BACKGROUND: The common cold or upper respiratory infection (URI) is highly prevalent in young children and often results in otitis media (OM). Incidence and characteristics of OM complicating URI by specific viruses have not been well studied. METHODS: We performed a prospective, longitudinal, cohort study of 294 healthy children (6 mos. to 3 yrs. of age). Each child was followed for 1 year for the occurrences of URI and acute otitis media (AOM) and otitis media with effusion (OME) complicating URI by specific viruses. RESULTS: There were 1295 URI episodes (5.06 episodes/child-year) and 440 AOM episodes (1.72 episodes/child-year) documented. Virus studies were performed in 864 URI episodes; 63% were virus positive. Rhinovirus and adenovirus were most commonly detected during URI. The overall incidence of OM complicating URI was 61%, including 37% AOM and 24% OME. Young age was the most important predictor for AOM complicating URI. AOM occurred in about half of children with URI associated with adenovirus, respiratory syncytial virus (RSV), and coronavirus, and about one-third of those with influenza, parainfluenza, enterovirus and rhinovirus. CONCLUSIONS: More than 60% of symptomatic URI episodes in young children were complicated by AOM and/or OME. Young age and specific virus types were predictors of AOM complicating URI. Preventive strategy for OM should be through preventing viral URI in young children. The strategy may be more effective if the priority is given to development of ways to prevent URI associated with adenovirus and RSV.