Asthma may boost pneumococcal infection risk

NEW YORK (Reuters Health) - People with asthma are at increased risk of serious infection with pneumococcal bacteria, according to a new analysis of medical records.

The findings, along with the high fatality rate from such infections, suggest that adults with asthma would benefit from the pneumococcal vaccine, Dr. Young J. Juhn of the Mayo Clinic in Rochester, Minnesota and colleagues say. However, the ability of asthmatics to react normally to the vaccine must be determined before such recommendations can be made, they add.

A previous study found that Medicaid patients with asthma were more than twice as likely to contract invasive pneumococcal disease, in which pneumococcal pneumonia develops and the bacteria invades the bloodstream or the membranes surrounding the brain, Juhn and colleagues note.

To examine whether the infections might be associated with asthma in a different population, they analyzed records for all Rochester, Minnesota residents potentially diagnosed with serious pneumococcal disease between 1964 and 1983, a total of 3,941 people 2 to 64 years old. The researchers confirmed 174 cases, and matched each of these cases with two healthy controls.

People diagnosed with serious pneumococcal disease were 2.4 times as likely to have asthma, and the odds were 6.7 times greater among adults, even after the researchers considered the effects of smoking and other factors.

Because only 12 percent of the serious pneumococcal disease cases included in the study were in children, Juhn and his team point out that “meaningful conclusions” can’t be drawn for the children from the current findings.

Nevertheless, they add, “Adults with asthma might be at increased risk of invasive pneumococcal disease, pneumococcal pneumonia, or both. The mechanisms underlying this increased risk of serious pneumococcal disease among individuals with asthma requires further study.”

“In the meantime,” they recommend “consideration should be given to including asthma as an indication for pneumococcal vaccination in adults.”

SOURCE: Journal of Allergy and Clinical Immunology, October 2008.

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