Recurrent wheezing after rhinovirus bronchiolitis.

The occurrence of wheezing in infants affected by Respiratory Syncytial Virus(RSV) bronchiolitis, is well documented whereas the contribution of viruses other than RSV, is not yet established. Our aim was to evaluate the role of 14 respiratory viruses for subsequent wheezing after acute bronchiolitis. 139 infants(mean age±SD: 2.4±2m, range:0.7-11m, 83 males), hospitalized with moderate-severe bronchiolitis during 3 years period (October 2004-January 2007), were evaluated for the presence of wheezing after 24 months follow-up. On admission nasopharyngeal swabs were analyzed for RSV, Influenza A and B, Adenovirus, Rhinovirus(RV) and Parainfluenza virus(PIV) 1-3, Metapneumovirus(hMPV), Coronavirus(hCoV), Bocavirus(hBoV), by R-T PCR. Parents of all infants were interviewed by telephone about the presence of wheezing episodes in their children at 12 and 24 months after bronchiolitis. Viruses were identified in 82(59%) infants: RSV in 59(72%), RV in 13(15.9%), hBoV in 7(8,5%), PIV1, hMPV, hCoV in 1(1.2%) each. 57(41%) infants were virus negative (VN).The percentage of infants with a positive family history for atopy was higher in children with wheezing at 24 months as compared to children without wheezing (53.8%vs46.2%, p=0.005). 73.2% of children with wheezing after 12 months, still showed wheezing after 24 months (p=0.01). A higher percentage of children with wheezing after 24 months was documented in infants with RV bronchiolitis comparing to patients with bronchiolitis from other viruses (76.9%vs50%, vs39.2% and vs35.6%; p<0.05, RV, hBoV, VN and VRS, respectively). In conclusion, infants with bronchiolitis from RV are those with a higher probability to have episodes of wheezing during the first 2 years of life.