August 15, 2008

Airway infection’s spread raises concerns

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Kecia Carroll, M.D.

Airway infection’s spread raises concerns

Investigators at the Monroe Carell Jr. Children's Hospital at Vanderbilt and Vanderbilt University Hospital have documented a recent 40 percent rise in bronchiolitis, an airway infection often linked with respiratory syncitial virus (RSV).

As part of a larger review of health care claims, called the Tennessee Asthma Bronchiolitis Study (TABS), Kecia Carroll, M.D., assistant professor of Pediatrics, and Tina Hartert, M.D., associate professor of Medicine, looked at children enrolled in TennCare between 1995 and 2003.

Recent studies have shown a rise in rates of infants hospitalized for bronchiolitis, and this research confirms the problem is widespread outside the hospital as well.

"All of the babies in this study were term, normal birth weight, and had no serious health issues like heart or lung disease,” Carroll said. “We found rates of health care visits for bronchiolitis rose 40 percent since the mid '90s, although the reasons for the increase are not known.”

The study appeared in the July issue of Pediatrics. The research team confirmed several risk factors associated with higher rates of bronchiolitis in infants, including the presence of other siblings, living in rural areas and having a young mother.

“Older maternal age was protective. Babies born to mothers in their 30s and 40s had significantly lower risk,” Carroll said. The high rate of increase in babies being seen in Tennessee emergency departments and doctors offices for breathing problems associated with bronchiolitis likely reflects what is happening in other parts of the nation as well.

"The burden of disease is very real and this health care burden is important. While we did not test for the cause of the bronchiolitis, there is a strong connection with the RSV season, and previous studies have shown that 50 percent to 70 percent of bronchiolitis in winter is caused by RSV,” Carroll said. “This highlights the importance of the challenging work others are doing to develop a safe and effective vaccine.”

In the meantime, actions such as limiting contact with individuals who have colds, frequent hand washing, and avoiding tobacco smoke are things parents can do to help protect babies from viral infections.