Vaccine and Infectious Disease Division

Scoring symptoms of the common cold in children

The high number of diverse respiratory pathogens associated with the common cold poses a challenge for researchers studying viral upper respiratory infections (URIs). A vast repertoire of viruses, bacteria, and allergies can cause cold-like symptoms, complicating treatment decisions and clinical studies of candidate anti-viral therapies, where inclusion of subjects with non-viral “colds” could obfuscate study results.  While molecular detection techniques exist that can definitively identify respiratory viruses, this process is expensive and labor intensive.  Cost effective systems to reliably differentiate viral URIs from other cold-like illnesses exist for adults, based on self-assessment of symptoms, but those systems do not translate effectively to children, where young age hinders self-reporting.

To address this difficulty, VIDD affiliate investigator Dr. Janet Englund and colleagues developed a new symptom-based assessment system designed specifically for young children.  The researchers enrolled healthy children 2-11 years of age in the Seattle area and asked their parents to immediately report if they thought their child was coming down with a cold.  For those children, a nasal secretion was obtained and analyzed for common cold-causing viruses to determine if they truly had a viral URI.  The researchers also asked parents to keep a 14-day diary tracking the severity of 12 potential cold symptoms.  From this data, the researchers identified symptoms or severities of symptoms that differed between the children with identifiable viral URIs and children who had no detectable virus.  The researchers determined that the most effective model tracked “significant” runny nose and “significant” cough over the first four days of symptoms.  Using these two criteria, the model showed 81.4% sensitivity, 61.9% specificity and 73.3% accuracy.  A method to easily distinguish viral from non-viral cold-like illnesses will be helpful to determine efficacy of study interventions in children.

Taylor JA, Weber WJ, Martin ET, McCarty RL, Englund JA. Development of a symptom score for clinical studies to identify children with a documented viral upper respiratory tract infection. Pediatr Res. 2010 Jun 1.