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Childhood Infections and the Risk of Asthma

A Longitudinal Study Over 37 Years

      Background

      Few studies have examined common childhood infections and adult asthma. We examined associations between childhood infectious diseases, childhood pneumonia, and current, persisting, and incident asthma to middle age.

      Methods

      We analyzed data from the Tasmanian Longitudinal Health Study (TAHS). A history of pneumonia was ascertained from their parents when the TAHS participants were 7 years old. Measles, rubella, mumps, chickenpox, diphtheria, and pertussis were identified from school medical records. Associations with current, persisting, or incident asthma were examined using regression techniques.

      Results

      Greater infectious diseases load was negatively associated with persisting asthma at all ages. Individually, pertussis (adjusted OR [aOR], 0.53; 95% CI, 0.28–1.00) was negatively associated with asthma persisting to age 13 years, chickenpox (aOR, 0.58; 95% CI, 0.38–0.88) was negatively associated with asthma persisting to age 32 years, and rubella was negatively associated with asthma persisting to ages 32 (aOR, 0.61; 95% CI, 0.31–0.96) and 44 years (aOR 0.53; 95% CI, 0.35–0.82). Pertussis was associated with preadolescent incident asthma (adjusted hazard ratio [aHR], 1.80; 95% CI, 1.10–2.96), whereas measles was associated with adolescent incident asthma (aHR, 1.66; 1.06–2.56). Childhood pneumonia was associated with current asthma at ages 7 (aOR, 3.12; 95% CI, 2.61–3.75) and 13 years (aOR, 1.32; 95% CI, 1.00–1.75), an association stronger in those without than those with eczema (aOR, 3.46; 95% CI, 2.83–4.24 vs aOR, 2.08; 95% CI, 1.38–3.12).

      Conclusions

      Overall, childhood infectious diseases protected against asthma persisting in later life, but pertussis and measles were associated with new-onset asthma after childhood. Measles and pertussis immunization might lead to a reduction in incident asthma in later life.
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      References

        • Clark NA
        • Demers PA
        • Karr CJ
        • et al.
        Effect of early life exposure to air pollution on development of childhood asthma.
        Environ Health Perspect. 2010; 118: 284-290
        • Dietert RR
        • Zelikoff JT
        Early-life environment, developmental immunotoxicology, and the risk of pediatric allergic disease including asthma.
        Birth Defects Res B Dev Reprod Toxicol. 2008; 83: 547-560
        • Martinez FD
        The origins of asthma and chronic obstructive pulmonary disease in early life.
        Proc Am Thorac Soc. 2009; 6: 272-277
        • Sly PD
        • Kusel M
        • Holt PG
        Do early-life viral infections cause asthma?.
        J Allergy Clin Immunol. 2010; 125: 1202-1205
        • Clark CE
        • Coote JM
        • Silver DA
        • Halpin DM
        Asthma after childhood pneumonia: six year follow up study.
        BMJ. 2000; 320: 1514-1516
        • Piippo-Savolainen E
        • Remes S
        • Kannisto S
        • Korhonen K
        • Korppi M
        Asthma and lung function 20 years after wheezing in infancy: results from a prospective follow-up study.
        Arch Pediatr Adolesc Med. 2004; 158: 1070-1076
        • Chinn S
        • Janson C
        • Svanes C
        • Dharmage S
        • Jarvis D
        The relation of adult bronchial responsiveness to serious childhood respiratory illness in the ECRHS.
        Respir Med. 2007; 101: 983-988
        • Dharmage SC
        • Erbas B
        • Jarvis D
        • et al.
        Do childhood respiratory infections continue to influence adult respiratory morbidity?.
        Eur Respir J. 2009; 33: 237-244
        • Shaheen SO
        • Aaby P
        • Hall AJ
        • et al.
        Measles and atopy in Guinea-Bissau.
        Lancet. 1996; 347: 1792-1796
        • Paunio M
        • Heinonen OP
        • Virtanen M
        • Leinikki P
        • Patja A
        • Peltola H
        Measles history and atopic diseases: a population-based cross-sectional study.
        JAMA. 2000; 283: 343-346
        • Farooqi IS
        • Hopkin JM
        Early childhood infection and atopic disorder.
        Thorax. 1998; 53: 927-932
        • Bodner C
        • Godden D
        • Seaton A
        • The Aberdeen WHEASE Group
        Family size, childhood infections and atopic diseases.
        Thorax. 1998; 53: 28-32
        • Gibson HB
        • Silverstone H
        • Gandevia B
        • Hall GJ
        Respiratory disorders in seven-year-old children in Tasmania. Aims, methods and administration of the survey.
        Med J Aust. 1969; 2: 201-205
        • Giles GG
        • Lickiss N
        • Gibson HB
        • Shaw K
        Respiratory symptoms in Tasmanian adolescents: a follow up of the 1961 birth cohort.
        Aust N Z J Med. 1984; 14: 631-637
        • Jenkins MA
        • Hopper JL
        • Bowes G
        • Carlin JB
        • Flander LB
        • Giles GG
        Factors in childhood as predictors of asthma in adult life.
        BMJ. 1994; 309: 90-93
        • Wharton C
        • Dharmage S
        • Jenkins M
        • et al.
        Tracing 8,600 participants 36 years after recruitment at age seven for the Tasmanian Asthma Study.
        Aust N Z J Public Health. 2006; 30: 105-110
        • Nakajima K
        • Dharmage SC
        • Carlin JB
        • et al.
        Is childhood immunisation associated with atopic disease from age 7 to 32 years?.
        Thorax. 2007; 62: 270-275
        • Hosmer Jr, DW
        • Lemeshow S
        Goodness-of-fit tests for the multiple logistic regression model. Communications in Statistics: Theory and Methods.
        Part A. 1980; 9: 1043-1069
        • StataCorp
        Stata Statistical Software: Release 10. Stata Corporation, College Station, TX2008
        • Strachan DP
        Hay fever, hygiene, and household size.
        BMJ. 1989; 299: 1259-1260
        • Douwes J
        • Pearce N
        Commentary: the end of the hygiene hypothesis?.
        Int J Epidemiol. 2008; 37: 570-572
        • Hinman AR
        • Orenstein WA
        • Bloch AB
        • et al.
        Impact of measles in the United States.
        Rev Infect Dis. 1983; 5: 439-444
        • Sabella C
        Measles: not just a childhood rash.
        Cleve Clin J Med. 2010; 77: 207-213
        • Heininger U
        • Klich K
        • Stehr K
        • Cherry JD
        Clinical findings in Bordetella pertussis infections: results of a prospective multicenter surveillance study.
        Pediatrics. 1997; 100: E10
        • O'Brien JA
        • Caro JJ
        Hospitalization for pertussis: profiles and case costs by age.
        BMC Infect Dis. 2005; 5: 57
        • Karp CL
        • Wysocka M
        • Wahl LM
        • et al.
        Mechanism of suppression of cell-mediated immunity by measles virus.
        Science. 1996; 273: 228-231
        • Onorato IM
        • Wassilak SG
        • Meade B
        Efficacy of whole-cell pertussis vaccine in preschool children in the United States.
        JAMA. 1992; 267: 2745-2749
        • Matheson MC
        • Haydn Walters E
        • Burgess JA
        • et al.
        Childhood immunization and atopic disease into middle-age—a prospective cohort study.
        Pediatr Allergy Immunol. 2010; 21: 301-306
        • von Mutius E
        Infection: friend or foe in the development of atopy and asthma? The epidemiological evidence.
        Eur Respir J. 2001; 18: 872-881
        • Liu AH
        Hygiene theory and allergy and asthma prevention.
        Paediatr Perinat Epidemiol. 2007; 21: 2-7
        • Castro-Rodríguez JA
        • Holberg CJ
        • Wright AL
        • et al.
        Association of radiologically ascertained pneumonia before age 3 yr with asthmalike symptoms and pulmonary function during childhood: a prospective study.
        Am J Respir Crit Care Med. 1999; 159: 1891-1897
        • Ferrari M
        • Tardivo S
        • Zanolin ME
        • et al.
        Serious childhood respiratory infections and asthma in adult life. A population based study. ECRHS Italy. European Community Respiratory Health Survey.
        Ann Allergy Asthma Immunol. 1999; 83: 391-396
        • Strachan DP
        • Butland BK
        • Anderson HR
        Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort.
        BMJ. 1996; 312: 1195-1199
        • Burgess JA
        • Walters EH
        • Byrnes GB
        • et al.
        Who remembers whether they had asthma as children?.
        J Asthma. 2006; 43: 727-730
        • Strachan DP
        • Griffiths JM
        • Johnston ID
        • Anderson HR
        Ventilatory function in British adults after asthma or wheezing illness at ages 0–35.
        Am J Respir Crit Care Med. 1996; 154: 1629-1635
        • Jenkins MA
        • Clarke JR
        • Carlin JB
        • et al.
        Validation of questionnaire and bronchial hyperresponsiveness against respiratory physician assessment in the diagnosis of asthma.
        Int J Epidemiol. 1996; 25: 609-616
        • Lynch T
        • Bialy L
        • Kellner JD
        • et al.
        A systematic review on the diagnosis of pediatric bacterial pneumonia: when gold is bronze.
        PLoS ONE. 2010; 5: e11989
        • Grossman LK
        • Caplan SE
        Clinical, laboratory, and radiological information in the diagnosis of pneumonia in children.
        Ann Emerg Med. 1988; 17: 43-46
        • Zukin DD
        • Hoffman JR
        • Cleveland RH
        • Kushner DC
        • Herman TE
        Correlation of pulmonary signs and symptoms with chest radiographs in the pediatric age group.
        Ann Emerg Med. 1986; 15: 792-796