Association of Picornavirus Infections With Acute Otitis Media in a Prospective Birth Cohort Study

J Infect Dis. 2020 Jun 29;222(2):324-332. doi: 10.1093/infdis/jiaa087.

Abstract

Background: Human rhinoviruses (HRVs), human enteroviruses (HEVs) and human parechoviruses (HPeVs) have been linked to acute otitis media (AOM). We evaluated this association in a prospective birth cohort setting.

Methods: A total of 324 healthy infants were followed up from birth to age 3 years. Nasal swab samples were collected at age 3, 6, 12, 18, 24, and 36 months and screened for HRV and HEV using real-time reverse-transcription quantitative polymerase chain reaction. Stool samples were collected monthly and analyzed for HRV, HEV, and HPeV. AOM episodes diagnosed by physicians were reported by parents in a diary. The association of viruses with AOM was analyzed using generalized estimation equations, and their relative contributions using population-attributable risk percentages.

Results: A clear association was found between AOM episodes and simultaneous detection of HEV (adjusted odds ratio for the detection of virus in stools, 2.04; 95% confidence interval, 1.06-3.91) and HRV (1.54; 1.04-2.30). HPeV showed a similar, yet nonsignificant trend (adjusted odds ratio, 1.44; 95% confidence interval, .81-2.56). HRV and HEV showed higher population-attributable risk percentages (25% and 20%) than HPeV (11%).

Conclusions: HEVs and HRVs may contribute to the development of AOM in a relatively large proportion of cases.

Keywords: acute otitis media; child; human enterovirus; human parechovirus; human rhinovirus; picornaviruses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Child, Preschool
  • Enterovirus / isolation & purification
  • Enterovirus Infections / complications
  • Enterovirus Infections / virology
  • Feces / virology
  • Female
  • Humans
  • Infant
  • Male
  • Nose / virology
  • Otitis Media / virology*
  • Parechovirus / isolation & purification*
  • Picornaviridae Infections / complications*
  • Picornaviridae Infections / virology
  • Prospective Studies
  • Rhinovirus / isolation & purification*