A Longitudinal Study of Respiratory Viruses and Bacteria in the Etiology of Acute Otitis Media with Effusion

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Abstract
We analyzed data from a 14-year longitudinal study of respiratory infections in young children to determine the relative importance of viral respiratory infection and nasopharyngeal colonization with Streptococcus pneumoniae and Haemophilus influenzae as factors influencing the occurrence of acute otitis media with effusion. The incidence of this disorder was increased in children with viral respiratory infections (average relative risk, 3.2; PStr. pneumoniae or H. influenzae had a lesser effect on the incidence of the disease (average relative risk, 1.5; P<0.01). Infections with the viruses more closely associated with acute otitis media (respiratory syncytial virus, adenovirus, and influenza A or B) were correlated with an increased risk of recurrent disease. Prevention of selected otitis-associated viral infections should reduce the incidence of this disease. (N Engl J Med. 1982; 306:1377–83.)

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