Abstract
Children with an early severe respiratory syncytial virus (RSV) infection have an increased risk of wheezing later in life. This longitudinal study aimed to investigate whether children with a mild RSV infection taken care of in a primary health care setting had an increased incidence of wheezing in the 2 years following infection compared to children with other respiratory infections (RSV-negative). Nasal swabs of children with acute respiratory infections were examined for 23 pathogens by multiplex PCR. 216 RSV-positive and RSV-negative (N = 201) matched for age, gender and time of diagnosis were followed for 2 years using telemedical control to record the occurrence of wheezing, hospitalization and frequency of respiratory tract infections. RSV-positive patients showed a 48% lower risk (OR 0.520, p = 0.03) of developing wheezing in the 2-year observation period compared to the RSV-negative group; Rhinovirus-positive patients had a trendwise increased risk (OR 1.47, p = 0.0872). These data were also reflected in a reduced prescription rate of short acting beta agonists in the RSV group. In conclusion, mild RSV infections led to fewer wheezing episodes in RSV-positive compared to RSV-negative patients. Rhinovirus infections appear to increase wheezing. Our data are consistent with the idea that there could be a dose-effect relationship with RSV infections.