Kids with lung disease prone to serious infections at daycare

A new study has revealed that exposure to common viruses in daycare puts children with a chronic lung condition caused by premature birth at risk for serious respiratory infections.

Johns Hopkins Children's Center researchers say their findings should prompt pediatricians to monitor their prematurely born patients, regardless of age, for signs of lung disease and to discuss the risks of daycare-acquired infections with the children's parents.

These risks, the researchers found, include increased emergency room visits and medication use and more days with breathing problems.

"Daycare can be a breeding ground for viruses and puts these already vulnerable children at risk for prolonged illness and serious complications from infections that are typically mild and short-lived in children with healthy lungs," said lead investigator Sharon McGrath-Morrow, MD, MBA, a lung specialist at Hopkins Children's.

Investigators interviewed the parents of 111 children ages 3 and under with chronic lung disease of prematurity (CLDP) about their child's daycare attendance, infections, symptoms, emergency room visits, hospitalizations and use of medications.

Among the 22 children with CLDP who attended daycare, 37% went to the ER for worsening symptoms since their last day in daycare, compared to 12% of children who did not attend daycare. More than 15%of those who attended daycare were hospitalized for viral illness, compared to 6%among those who didn't attend daycare.

Thirty-nine percent of those in daycare needed corticosteroids for their illness and 50%of them required antibiotics, compared to 19% and 26%, respectively, for those who were not in daycare. Children in daycare had more respiratory episodes in the week before their visit to the doctor. More than half of the children in daycare had respiratory symptoms in the week before their visit, compared to 29% of those not enrolled in daycare.

CLDP develops in about a quarter of babies born at or before 26 weeks of gestation, according to the investigators, but even those born as late as 32 weeks of gestation can develop the condition, the researchers say.

The study has been published in the October issue of Pediatrics.