Prospective multicenter study of the viral etiology of bronchiolitis in the emergency department

Jonathan M. Mansbach, Alexander J. McAdam, Sunday Clark, Paul D. Hain, Robert G. Flood, Uchechi Acholonu, Carlos A. Camargo

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Objectives: To determine the viral etiology of bronchiolitis and clinical characteristics of children age < 2 years presenting to the emergency department (ED) with bronchiolitis. Methods: The authors conducted a 14-center prospective cohort study during 2005-2006 of ED patients age < 2 years with bronchiolitis. The study was conducted in 10 states as part of the Emergency Medicine Network. Researchers collected nasopharyngeal aspirates and conducted structured interviews, medical record reviews, and 2-week follow-up telephone calls. Samples were tested using reverse transcription polymerase chain reaction for respiratory syncytial virus (RSV), rhinovirus (RV), human metapneumovirus (hMPV), and influenza viruses (Flu). Results: Testing of 277 samples revealed 176 (64%) positive for RSV, 44 (16%) for RV, 26 (9%) for hMPV, 17 (6%) for Flu A, and none for Flu B. When children were categorized as RSV only, RV only, RV and RSV, and all others (hMPV, Flu, no identified virus), children with RV only were more likely to be African American (19, 62, 14, and 40%, respectively; p < 0.001) and have a history of wheezing (23, 52, 21, and 15%, respectively; p = 0.01). In multivariate models, children with RV were more likely to receive corticosteroids (odds ratio [OR] 3.5; 95% confidence interval [CI] = 1.5 to 8.15). The duration of illness may be shorter for children with RV (Days 8, 3, 6, and 8; p = 0.07). Conclusions: In this multicenter study, RSV was the most frequent cause of bronchiolitis (64%). RV was present in 16%, and these children have a distinct profile in terms of demographics, medical history, and ED treatment.

Original languageEnglish (US)
Pages (from-to)111-118
Number of pages8
JournalAcademic Emergency Medicine
Volume15
Issue number2
DOIs
StatePublished - Feb 2008

Fingerprint

Viral Bronchiolitis
Rhinovirus
Multicenter Studies
Hospital Emergency Service
Respiratory Syncytial Viruses
Prospective Studies
Metapneumovirus
Bronchiolitis
Human Influenza
Emergency Treatment
Emergency Medicine
Respiratory Sounds
Orthomyxoviridae
Telephone
African Americans
Reverse Transcription
Medical Records
Adrenal Cortex Hormones
Cohort Studies
Odds Ratio

Keywords

  • Asthma
  • Bronchiolitis
  • Respiratory syncytial virus
  • Rhinovirus

ASJC Scopus subject areas

  • Emergency Medicine
  • Medicine(all)

Cite this

Prospective multicenter study of the viral etiology of bronchiolitis in the emergency department. / Mansbach, Jonathan M.; McAdam, Alexander J.; Clark, Sunday; Hain, Paul D.; Flood, Robert G.; Acholonu, Uchechi; Camargo, Carlos A.

In: Academic Emergency Medicine, Vol. 15, No. 2, 02.2008, p. 111-118.

Research output: Contribution to journalArticle

Mansbach, Jonathan M. ; McAdam, Alexander J. ; Clark, Sunday ; Hain, Paul D. ; Flood, Robert G. ; Acholonu, Uchechi ; Camargo, Carlos A. / Prospective multicenter study of the viral etiology of bronchiolitis in the emergency department. In: Academic Emergency Medicine. 2008 ; Vol. 15, No. 2. pp. 111-118.
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KW - Respiratory syncytial virus

KW - Rhinovirus

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