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Is Asthma an Infectious Disease?^*

Thomas A. Neff Lecture

^* From the Departments of Pediatrics and Medicine, Division of Pediatric Allergy, Immunology, and Rheumatology, University of Wisconsin Medical School, Madison, WI.

Correspondence to: Robert F. Lemanske, Jr, MD, Department of Pediatrics, University of Wisconsin Hospital, 600 Highland Ave, K4/916, Madison, WI 53792

Respiratory tract infections caused by viruses, Chlamydia, and Mycoplasma have been implicated in the pathogenesis of asthma. Of these respiratory pathogens, viruses have been demonstrated to be associated with asthma epidemiologically in at least two ways. First, during infancy, certain viruses have been implicated as potentially being responsible for the inception of the asthmatic phenotype. Second, in patients with established asthma, particularly children, viral upper respiratory tract infections play a significant role in producing acute exacerbations of airway obstruction that may result in frequent outpatient visits or in hospitalizations. For infections with other microbial agents, recent attention has focused on Chlamydia and Mycoplasma as potential contributors to both exacerbations and the severity of chronic asthma in terms of loss of lung function or medication requirements. In an attempt to address the question posed in the title, this article will briefly review these various associations as they pertain to the pathogenesis of asthma in both children and adults.

Key Words: asthma • Chlamydia • Mycoplasma • respiratory syncytial virus • rhinovirus • virus

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