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The causes and consequences of seasonal variation in COPD exacerbations.

Donaldson GC, Wedzicha JA - Int J Chron Obstruct Pulmon Dis (2014)

Bottom Line: The seasonality of exacerbations varies with latitude, and is greater in more temperate climates, where there may be less protection from outdoor and indoor cold exposure.Increased susceptibility to viral infection may also be a mechanism mediated through increased airway inflammation or possibly reduced vitamin D levels.The seasonality of exacerbations informs us about the triggers of exacerbations and suggests possible strategies to reduce their number.

View Article: PubMed Central - PubMed

Affiliation: Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK.

ABSTRACT
The time of year when patients experience exacerbations of chronic obstructive pulmonary disease is a much-overlooked feature of the disease. The higher incidence of exacerbations in winter has important consequences for patients in terms of increased morbidity and mortality. The seasonality also imposes a considerable burden on already-overloaded health care services, with both primary care consultations and hospital admissions increasing in number. The seasonality of exacerbations varies with latitude, and is greater in more temperate climates, where there may be less protection from outdoor and indoor cold exposure. The precise causes of the seasonality are unknown, but thought to be partly due to the increased prevalence of respiratory viral infections circulating in cold, damp conditions. Increased susceptibility to viral infection may also be a mechanism mediated through increased airway inflammation or possibly reduced vitamin D levels. The seasonality of exacerbations informs us about the triggers of exacerbations and suggests possible strategies to reduce their number.

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Related in: MedlinePlus

Weekly data on laboratory reports of respiratory virus isolation by the Health Protection Agency/Public Health England and National Health Service hospital laboratories in England and Wales.Notes: Data points are the average for that week over years 1980–2013. The y-axes show the number of viruses isolated per week. Adapted from Respiratory infections: laboratory reports 2014 [homepage on the internet]. Public Health England; 2014 [updated September 5, 2014]. Available from: https://www.gov.uk/government/publications/respiratory-infections-laboratory-reports-2014. Accessed September 24, 2014. Contains public sector information licensed under the Open Government Licence v2.0.77
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f5-copd-9-1101: Weekly data on laboratory reports of respiratory virus isolation by the Health Protection Agency/Public Health England and National Health Service hospital laboratories in England and Wales.Notes: Data points are the average for that week over years 1980–2013. The y-axes show the number of viruses isolated per week. Adapted from Respiratory infections: laboratory reports 2014 [homepage on the internet]. Public Health England; 2014 [updated September 5, 2014]. Available from: https://www.gov.uk/government/publications/respiratory-infections-laboratory-reports-2014. Accessed September 24, 2014. Contains public sector information licensed under the Open Government Licence v2.0.77

Mentions: Figure 5 shows viral isolation counts from Public Health Agency laboratories for 1980–2008 for all ages and sexes, by week number. Influenza A, RSV and Mycoplasma pneumoniae occur mainly in the winter to early spring, influenza B peaks in late spring, and parainfluenza in summer. Rhinoviruses, adenoviruses, and corona viruses occur throughout the year. Rhinovirus detection falls during the summer holidays, but rises around the time that the new academic year starts. Data from other countries will differ due to local social patterns and meteorological conditions, with the autumnal peak in the UK possibly not as pronounced as that observed in the US.56,57 One limitation of these data is that rates cannot be determined, as the number of people presenting to a physician with a respiratory infection is unknown. Furthermore, the decision to send a sample for investigation may be influenced by concerns over the latest global epidemic or the age of the patient, as samples from young children tend to predominate. Therefore, comparisons from year to year are somewhat problematic.


The causes and consequences of seasonal variation in COPD exacerbations.

Donaldson GC, Wedzicha JA - Int J Chron Obstruct Pulmon Dis (2014)

Weekly data on laboratory reports of respiratory virus isolation by the Health Protection Agency/Public Health England and National Health Service hospital laboratories in England and Wales.Notes: Data points are the average for that week over years 1980–2013. The y-axes show the number of viruses isolated per week. Adapted from Respiratory infections: laboratory reports 2014 [homepage on the internet]. Public Health England; 2014 [updated September 5, 2014]. Available from: https://www.gov.uk/government/publications/respiratory-infections-laboratory-reports-2014. Accessed September 24, 2014. Contains public sector information licensed under the Open Government Licence v2.0.77
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4199860&req=5

f5-copd-9-1101: Weekly data on laboratory reports of respiratory virus isolation by the Health Protection Agency/Public Health England and National Health Service hospital laboratories in England and Wales.Notes: Data points are the average for that week over years 1980–2013. The y-axes show the number of viruses isolated per week. Adapted from Respiratory infections: laboratory reports 2014 [homepage on the internet]. Public Health England; 2014 [updated September 5, 2014]. Available from: https://www.gov.uk/government/publications/respiratory-infections-laboratory-reports-2014. Accessed September 24, 2014. Contains public sector information licensed under the Open Government Licence v2.0.77
Mentions: Figure 5 shows viral isolation counts from Public Health Agency laboratories for 1980–2008 for all ages and sexes, by week number. Influenza A, RSV and Mycoplasma pneumoniae occur mainly in the winter to early spring, influenza B peaks in late spring, and parainfluenza in summer. Rhinoviruses, adenoviruses, and corona viruses occur throughout the year. Rhinovirus detection falls during the summer holidays, but rises around the time that the new academic year starts. Data from other countries will differ due to local social patterns and meteorological conditions, with the autumnal peak in the UK possibly not as pronounced as that observed in the US.56,57 One limitation of these data is that rates cannot be determined, as the number of people presenting to a physician with a respiratory infection is unknown. Furthermore, the decision to send a sample for investigation may be influenced by concerns over the latest global epidemic or the age of the patient, as samples from young children tend to predominate. Therefore, comparisons from year to year are somewhat problematic.

Bottom Line: The seasonality of exacerbations varies with latitude, and is greater in more temperate climates, where there may be less protection from outdoor and indoor cold exposure.Increased susceptibility to viral infection may also be a mechanism mediated through increased airway inflammation or possibly reduced vitamin D levels.The seasonality of exacerbations informs us about the triggers of exacerbations and suggests possible strategies to reduce their number.

View Article: PubMed Central - PubMed

Affiliation: Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK.

ABSTRACT
The time of year when patients experience exacerbations of chronic obstructive pulmonary disease is a much-overlooked feature of the disease. The higher incidence of exacerbations in winter has important consequences for patients in terms of increased morbidity and mortality. The seasonality also imposes a considerable burden on already-overloaded health care services, with both primary care consultations and hospital admissions increasing in number. The seasonality of exacerbations varies with latitude, and is greater in more temperate climates, where there may be less protection from outdoor and indoor cold exposure. The precise causes of the seasonality are unknown, but thought to be partly due to the increased prevalence of respiratory viral infections circulating in cold, damp conditions. Increased susceptibility to viral infection may also be a mechanism mediated through increased airway inflammation or possibly reduced vitamin D levels. The seasonality of exacerbations informs us about the triggers of exacerbations and suggests possible strategies to reduce their number.

Show MeSH
Related in: MedlinePlus