Early Respiratory Infection May Double Type 1 Diabetes Risk: Study

Researchers looked at children who had first-degree relatives with the autoimmune disease

By Serena Gordon

HealthDay Reporter

MONDAY, July 1 (HealthDay News) -- What may seem like a harmless cold during the first six months of life may more than double a child's chances of developing antibodies that often lead to type 1 diabetes, new German research suggests.

Infections that occur later don't seem to pose as high as risk. When infants between 6 and 12 months had a respiratory illness, their risk only increased by 32 percent, the study found.

The researchers noted that these findings probably don't apply to all youngsters, because this study was done with children who have a high risk of developing the disease because they have a first-degree relative who has type 1 diabetes.

"In general, the early immune system is still in a phase of development, and may therefore be particularly susceptible for challenges by infectious agents. However, we cannot explain yet why specifically respiratory infections might be relevant in this phase," said study author Andreas Beyerlein, head of the working group on epidemiology at the Institute of Diabetes Research in Munich.

Results of the study were published online July 1 in JAMA Pediatrics.

Infections have long been suspected as potential triggers of type 1 diabetes. Type 1 diabetes is an autoimmune condition that causes the body's immune system to mistakenly attack and destroy insulin-producing beta cells in the pancreas, according to background information in the study. Insulin is a hormone needed to metabolize the carbohydrates in foods so that they can be used as fuel for the body and brain.

Substances called islet autoantibodies appear in the blood before the development of type 1 diabetes, sometimes years before diabetes is evident. These autoantibodies help researchers predict whether or not someone will develop type 1 diabetes.

In the current study, the researchers followed 148 children who were under 3 months old when they started the study. All of the babies had a first-degree relative with type 1 diabetes.

When the children were 3 months old, the parents were asked to complete a detailed questionnaire that included information about their baby's history of infections, fever and medication use. They were asked to detail the types of symptoms their child had. They were also asked about family history of diabetes, and questions about lifestyle factors, such as whether the mother smoked during pregnancy.

Parents were then asked to record information about any illnesses or diseases that occurred until the child was 3 years old. The children also had their blood tested every three months to look for evidence that they had developed islet autoantibodies.

Over the three-year study, there were 1,245 infectious "events." Most -- 669 -- were respiratory infections that affected the upper respiratory tract, including the ear, nose, throat or eye. Infections that affected the digestive system totaled 257, and another 319 cases were classified as "other" infections, such as skin infections.

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Reducing Respiratory Virus in Preemies Lessens Wheezing: Study

But preventing respiratory synctial virus comes with a hefty price tag

By Serena Gordon

HealthDay Reporter

WEDNESDAY, May 8 (HealthDay News) -- Many pre-term babies suffer recurrent episodes of wheezing. Now, researchers say a common infection is a likely culprit and they may be able to prevent the breathing problems.

Wheezing episodes in late pre-term babies often are caused by infection with the respiratory synctial virus (RSV), the researchers said. And they've found that injections of an expensive RSV medication can prevent the virus -- and the wheezing.

A study of more than 400 babies born late pre-term (between 33 and 35 weeks' gestation) found that days with wheezing dropped by more than 60 percent among those who received injections of palivizumab during RSV season. The effect lasted even after treatment ended.

"In pre-term babies, RSV illnesses seem to be a risk factor for wheezing, and this treatment reduced that risk," said Dr. Robert Lemanske Jr., a professor of pediatrics and medicine at the University of Wisconsin School of Medicine and Public Health, in Madison. Lemanske wrote an editorial accompanying the new study, which was published May 9 in the New England Journal of Medicine.

RSV is a global health threat in the first year of life and the second leading cause of death after malaria, said study lead author Dr. Louis Bont, a pediatric infectious disease specialist at the University Medical Center Utrecht in the Netherlands.

"The risk of hospitalization for RSV bronchiolitis in otherwise healthy late pre-term [babies] is 5 percent," Bont said. "For other pre-terms, it is higher. About half of all otherwise healthy late pre-terms develop wheezing illness."

RSV-related wheezing reduces quality of life, and it has been linked to the development of asthma, Bont said. It's not yet clear if using palivizumab to prevent RSV will lower rates of asthma, he added.

RSV season lasts about four to five months during the fall, winter or spring, but the exact timing in the United States varies by region, according to the U.S. Centers for Disease Control and Prevention. There is no vaccine for the virus, which causes only mild symptoms in adults and older children.

The study was funded by Abbott Laboratories and the Netherlands Organization for Health Research and Development. Abbott markets palivizumab in some foreign countries.

The researchers set out to determine if RSV was the cause of wheezing illness during the first year of life. Studying 429 babies in the Netherlands, they randomly assigned half to receive a monthly injection of palivizumab during RSV season. The other half received a placebo drug.

The babies in the treatment group had 61 percent fewer days of wheezing during the first year of life. This led the researchers to conclude that RSV is a likely contributor to wheezing illness in this group of children.

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Study Reveals How New Respiratory Virus Spreads

Infectious-disease experts went to Middle East to gather information on often deadly MERS virus

By Robert Preidt

HealthDay Reporter

WEDNESDAY, June 19 (HealthDay News) -- The new respiratory virus responsible for an ongoing outbreak in the Middle East poses a serious risk to hospitals because it is easily transmitted in health care facilities, according to a new study.

A team of infectious-disease experts traveled to Saudi Arabia to investigate the spread of the Middle East respiratory syndrome coronavirus (MERS-CoV) in four Saudi hospitals in May. They concluded that the new virus was even more deadly than the related SARS (severe acute respiratory syndrome) virus that caused an outbreak in Toronto hospitals in 2003.

Not only is MERS-CoV easily transmitted from patient to patient, but also from hospital to hospital when sick patients are transferred, according to the study, which was published online June 19 in the New England Journal of Medicine.

"Our investigation showed some surprising similarities between MERS and SARS. Both are very deadly viruses and easily transferred between people, and even between health care facilities," team member Dr. Trish Perl, senior hospital epidemiologist for Johns Hopkins Medicine and a professor at the Johns Hopkins University School of Medicine, said in a Johns Hopkins news release.

At the time of the investigation, 23 people in Saudi Arabia had been infected with MERS-CoV and 11 had died of the virus. The death toll in that country now stands at 32, with 49 people infected, according to the most recent report from the U.S. Centers for Disease Control and Prevention.

In Saudi Arabia, swift action by local health officials to monitor the disease -- including rapid detection, isolation and treatment of infected patients -- has largely helped stem the outbreak, Perl said.

In addition, hospitals have ramped up infection control by introducing stronger disinfectants, requiring health care workers to follow strict procedures (such as wearing masks, gowns and gloves), giving infected patients private rooms and providing masks for uninfected patients in the vicinity.

The investigators also found that the death rate for MERS was much higher than for SARS: 48 percent versus 8 percent, respectively. But the MERS death rate may decrease if more cases -- including patients with mild symptoms -- are identified, the experts said.

The time from MERS exposure to the first signs of infection is about a little more than five days. Symptoms include coughing, shortness of breath, fever and vomiting. It took an average of about eight days for the virus to spread from one person to another, the findings showed.

"The story of how this outbreak occurred and how this virus was transmitted became very clear once we started to lay out the evidence and saw that one infected patient had been in the hospital at the same time as another infected patient, and this patient was transferred to another hospital, where another patient became infected shortly thereafter," Perl said in the news release.

Knowing this information is critical to halting future MERS outbreaks because it reveals how long health officials have to act before a person exposed to the virus begins to show symptoms and when people they infect also start to show symptoms, the researchers said.

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Little-Known Respiratory Infection Sends Many Kids to Hospital

Title: Little-Known Respiratory Infection Sends Many Kids to Hospital
Category: Health News
Created: 2/13/2013 6:36:00 PM
Last Editorial Review: 2/14/2013 12:00:00 AM

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