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130 – Human metapneumovirus and asthma
S278
METHODS 5,482 interviews were conducted globally online, by telephone & face-to-face: 1,733 physicians & 1,726 asthma patients in a 16-country adult arm; 1,006 physicians treating children with asthma & 1,017 parents of children with asthma in a 9-country pediatric arm. In North America, 304 pediatric physicians & 314 parents of pediatric patients were surveyed.
RESULTS Of patients who have taken asthma medication, parents report 29% experienced short-term side effects; 5% experienced long-term side effects. Side effects lead to patients switching or discontinuing treatment (39% considered switching medications, 36% switched medication & 32% skipped doses). 60% of parents say their child does not take medication according to physician’s instructions 100% of the time; physicians say their average patient takes medication according to instructions 56% of the time. Those who are not compliant all of the time experienced: increased symptoms (67%); limited physical activity (47%); more frequent attacks or exacerbations (39%); nighttime awakenings (32%); more physician visits (24%); absences from school (26%).
CONCLUSIONS Compliance is low & according to parents, experience with side effects appears to be an important factor; compliance appears directly linked to an increased symptomatology & resource utilization. In addition, the availability of new ICS treatment options with comparable efficacy & improved safety & tolerability might enhance patient outcomes. DOI: 10.1016/j.prrv.2006.04.037
A12/130 – Human metapneumovirus and asthma A. Goh, N. Tee, L.H. Loo, O.M. Chay, R. Lin, J. Tang, K.C. Ng, A.H. Teo and M.Y. Z Binte KK Women’s and Children’s Hospital, Singapore
AIM To determine the frequency of respiratory viruses and in particular metapneumovirus infection in children presenting with an asthma exacerbation.
METHOD Children presenting to the Children’s Emergency or admitted with an asthma exacerbation were enrolled after informed consent was taken. An asthma exacerbation was defined as the presence of wheeze in a child with physiciandiagnosed asthma OR a past history of at least 3 previous
POSTER PRESENTATIONS
episodes of wheeze. A nasopharyngeal swab was taken and sent for identification of metapneumovirus and rhinovirus by PCR and respiratory viruses by immunofluorescence.
RESULTS 298 children were enrolled of which 200 were inpatients and 98 outpatients. The mean age was 6.44 yrs (Range: 0.78–18.97 yrs). 62.4% were boys. 61.7% of the children had intermittent asthma while 38.3% had persistent asthma. Children with persistent asthma were more likely to be admitted during an asthma exacerbation (p < 0.001, OR = 126.0, 95% CI 17.2–129.5). Viruses were detected in 50.3% of children. Human metapneumovirus was present in 5% of children. The commonest virus isolated was rhinovirus (39.2%). Coinfection with 2 viruses was present in 4 children. Mean duration of hospital stay was 3 days (Range: 1–6days). Those with dual infections did not stay longer.
CONCLUSIONS Human Metapneumovirus infection was identified in children presenting with asthma exacerbations and may have a role as a viral trigger. Rhinoviruses remain the main viral agent identified in asthma exacerbations. DOI: 10.1016/j.prrv.2006.04.038
A13/305 – IgE and IgG anti-house dust mite specificities in asthma patients W.R. Thomas1, B.J. Hales1, A.C. Martin2 and P.N. LeSouef3 1 Telethon Institute for Child Health Research, Perth, Australia; 2Princess Margaret Hospital, Perth, Australia; 3 University of Western Australia, Perth, Australia Allergy to the house dust mite is found in about 80% of asthmatic children in Australia. Many of the strategies that could make immunotherapy a first choice treatment such as the administration of recombinant allergens and peptides will require the selection of an effective formulation of allergens. The large IgE responses induced by the Der p 1 and Der p 2 allergens have been known for some time but their relative importance has not been ascertained because of the lack of knowledge of the IgE binding of the other allergens and their representation in house dust mite extracts compared to inhaled air. Here, a 9-allergen panel known to be able to absorb out the IgE binding to the house dust mite specificities found in extracts, has been used compare the IgE binding in quantitative assays. The sum of the IgE binding to the different allergens correlated well with the IgE binding measured with extract by CAP assay. The combined IgE binding to Der p 1 and 2 accounted for 60% of all the IgE binding and except for very low IgE binders this percentage was found for patients
METHODS 5,482 interviews were conducted globally online, by telephone & face-to-face: 1,733 physicians & 1,726 asthma patients in a 16-country adult arm; 1,006 physicians treating children with asthma & 1,017 parents of children with asthma in a 9-country pediatric arm. In North America, 304 pediatric physicians & 314 parents of pediatric patients were surveyed.
RESULTS Of patients who have taken asthma medication, parents report 29% experienced short-term side effects; 5% experienced long-term side effects. Side effects lead to patients switching or discontinuing treatment (39% considered switching medications, 36% switched medication & 32% skipped doses). 60% of parents say their child does not take medication according to physician’s instructions 100% of the time; physicians say their average patient takes medication according to instructions 56% of the time. Those who are not compliant all of the time experienced: increased symptoms (67%); limited physical activity (47%); more frequent attacks or exacerbations (39%); nighttime awakenings (32%); more physician visits (24%); absences from school (26%).
CONCLUSIONS Compliance is low & according to parents, experience with side effects appears to be an important factor; compliance appears directly linked to an increased symptomatology & resource utilization. In addition, the availability of new ICS treatment options with comparable efficacy & improved safety & tolerability might enhance patient outcomes. DOI: 10.1016/j.prrv.2006.04.037
A12/130 – Human metapneumovirus and asthma A. Goh, N. Tee, L.H. Loo, O.M. Chay, R. Lin, J. Tang, K.C. Ng, A.H. Teo and M.Y. Z Binte KK Women’s and Children’s Hospital, Singapore
AIM To determine the frequency of respiratory viruses and in particular metapneumovirus infection in children presenting with an asthma exacerbation.
METHOD Children presenting to the Children’s Emergency or admitted with an asthma exacerbation were enrolled after informed consent was taken. An asthma exacerbation was defined as the presence of wheeze in a child with physiciandiagnosed asthma OR a past history of at least 3 previous
POSTER PRESENTATIONS
episodes of wheeze. A nasopharyngeal swab was taken and sent for identification of metapneumovirus and rhinovirus by PCR and respiratory viruses by immunofluorescence.
RESULTS 298 children were enrolled of which 200 were inpatients and 98 outpatients. The mean age was 6.44 yrs (Range: 0.78–18.97 yrs). 62.4% were boys. 61.7% of the children had intermittent asthma while 38.3% had persistent asthma. Children with persistent asthma were more likely to be admitted during an asthma exacerbation (p < 0.001, OR = 126.0, 95% CI 17.2–129.5). Viruses were detected in 50.3% of children. Human metapneumovirus was present in 5% of children. The commonest virus isolated was rhinovirus (39.2%). Coinfection with 2 viruses was present in 4 children. Mean duration of hospital stay was 3 days (Range: 1–6days). Those with dual infections did not stay longer.
CONCLUSIONS Human Metapneumovirus infection was identified in children presenting with asthma exacerbations and may have a role as a viral trigger. Rhinoviruses remain the main viral agent identified in asthma exacerbations. DOI: 10.1016/j.prrv.2006.04.038
A13/305 – IgE and IgG anti-house dust mite specificities in asthma patients W.R. Thomas1, B.J. Hales1, A.C. Martin2 and P.N. LeSouef3 1 Telethon Institute for Child Health Research, Perth, Australia; 2Princess Margaret Hospital, Perth, Australia; 3 University of Western Australia, Perth, Australia Allergy to the house dust mite is found in about 80% of asthmatic children in Australia. Many of the strategies that could make immunotherapy a first choice treatment such as the administration of recombinant allergens and peptides will require the selection of an effective formulation of allergens. The large IgE responses induced by the Der p 1 and Der p 2 allergens have been known for some time but their relative importance has not been ascertained because of the lack of knowledge of the IgE binding of the other allergens and their representation in house dust mite extracts compared to inhaled air. Here, a 9-allergen panel known to be able to absorb out the IgE binding to the house dust mite specificities found in extracts, has been used compare the IgE binding in quantitative assays. The sum of the IgE binding to the different allergens correlated well with the IgE binding measured with extract by CAP assay. The combined IgE binding to Der p 1 and 2 accounted for 60% of all the IgE binding and except for very low IgE binders this percentage was found for patients