Childhood wheeze is a common phenomenon, and
has seasonal prominence, largely focused on a viral respiratory syncytial
infection (RSV). When children wheeze again, or repeatedly, and a RSV infection
was previously documented, a ready explanation is available.
Recent data strongly supports the likelihood
of rhinovirus as the agent for the next sequence wheeze, and with the recurrent
wheeze a risk for asthma development. Without a RSV vaccination this postbronchiolitis wheezer
will fit the profile offered in the original review.
There remains however, as mentioned in 2003, a
concern these postbronchiolitis wheezers can morph into asthma, and a recent
study suggest a genetic association. This “phenotype” was more recently
discussed, but termed “severe intermittent wheeze”. Atopic features and
eventual asthma, however was not uncommon in the phenotype discussed. It seems
the medical community in 2016 still struggles with the post-RSV phenotype.
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