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Objective. To evaluate the effect of uncomplicated viral respiratory infections (colds) on middle ear pressure in healthy school-aged children. Methods. Children (ages 2-12) with normal tympanograms before onset of illness had bilateral tympanometry daily except weekends for 2 weeks after the onset of a cold. Nasopharyngeal secretion obtained at onset of illness was cultured for bacterial pathogens of otitis media using selective agars and tested for rhinovirus, coronavirus, respiratory syncytial virus, influenza A and B, and parainfluenza 1-3 by reverse transcriptase polymerase chain reaction technology. Tympanometry was designated as abnormal with peak pressure of [less than or equal to] -100 daPa or [greater than or equal to] 50 daPa and/or a compliance peak of Results. Eighty-six colds were studied, 82 in schoolchildren (5-12 years old) and 4 in 2- to 3-year-olds. Abnormal negative middle ear pressure occurred at least once during the 2 weeks after onset in 57 (66%) of the 86 colds. Tympanometry was abnormal in the first week after onset in 50 (88%) of the 57 colds and was abnormal on a single day in 17 (30%) of the 57. The middle ear pressure abnormalities were intermittent and shifted from one ear to the other ear from day to day. Reverse transcriptase polymerase chain reaction was positive for a respiratory virus in 56 (65%) of the 86 illnesses. Rhinovirus was found in 48% and respiratory syncytial virus in 14%. Pathogenic bacteria (Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis) were detected in nasopharyngeal secretion in 29 (34%) of the 86 colds; the bacteria were in high titer ([greater than or equal to] [10.sup.3] cfu/mL) in 26 of the 29 positive specimens. None developed illness that required a visit to a physician. Age, detection of a respiratory virus, and presence of bacterial pathogen in the nasopharyngeal secretion had a negligible effect on the occurrence of abnormal tympanometry. Occurrence of negative middle ear pressure in winter-spring colds was significantly greater than in fall colds for unexplained reasons. Conclusions. Transient negative middle ear pressure occurred in two thirds of uncomplicated colds in healthy children. This negative pressure, which may facilitate secondary viral or bacterial otitis media, seems to result from viral infection of the nasopharynx and distal tube causing bilateral eustachian tube dysfunction. Tympanometry provides an objective measure of the potential beneficial effects of investigational treatments on the risk of eustachian tube dysfunction/otitis media. Pediatrics 2002;109:826-832; otitis media, eustachian tube, viral respiratory infections, tympanometry., Otitis media is the most common diagnosis for which antibiotics are prescribed for children in the United States. This diagnosis has increased in frequency by 250% over a 15-year period [...]

A common cold during the first three months of pregnancy may increase the risk of birth defects. Researchers have found that colds with or without fever were most closely related to defects in the central nervous system and facial anomalies. These defects included anencephalus, spina bifida, hydrocephalus, cleft lip and undescended testicles. Women who were exposed to a cold in the first trimester had a 40% increased risk of birth defects. No impact on the results occurred from adjustment for maternal age, parity, severe vomiting in early pregnancy, threatened abortion and paternal smoking. Cautious interpretation of these findings is advised. It is possible that medications taken for colds, rather than the colds themselves, are the cause of malformations., ABSTRACT. Objective. To examine the association between the common cold with or without fever in the first 3 months of pregnancy and birth defects in offspring. Design. A case-control study. Setting. Data are from the Shanghai Birth Defects Monitoring Program, conducted in 29 hospitals in Shanghai, China from October 1, 1986 to September 30, 1987. Subjects. A total of 986 birth defects cases, 990 frequency-matched live birth controls, and 159 stillbirth controls. Results. Modestly elevated risk of birth defects was identified among women who reported having a cold with or without fever in the first trimester of pregnancy. Notably increased relative risks were observed for anencephalus (odds ratio [OR] = 3.9, 95% confidence interval [CI] = 2.0 to 7.7), spina bifida (OR = 4.1, 95% CI = 1.7 to 9.7), hydrocephalus (OR = 2.3, 95 (CI = 1.1 to 5.1), cleft lip (OR = 2.2, 95 % CI = 1.4 to 3.4), and undescended testicle (OR = 1.8, 95 (CI = 1.0 to 3.0). Our study further found that the overall relative risks were consistent by using two different control groups, suggesting that this association was unlikely to be due to recall or report bias. Conclusion. Common cold in the first trimester of pregnancy may be associated with an increased risk of birth defects in offspring. However, these findings should be interpreted cautiously. Pediatrics 1993; 92:559-563; birth defect, cold, fever, pregnancy

Current recommendations on measles vaccination suggest that minor illnesses with or without accompanying fever are not a good reason to avoid giving the vaccine. Because some vaccinations have been deferred due to minor illness, unvaccinated children have gone on to develop measles. Not all cases of measles are due to lack of vaccination. Some children experience primary vaccine failure, where the vaccine does not induce the immune response necessary to protect against the illness. Some of these vaccine failures are due to residual antibodies the infant's mother passes on which are interfering with the vaccine. Other failures may be attributed to inappropriate handling of the vaccine. A new study suggests that some children with minor upper respiratory infections with or without fever appear to experience primary measles vaccine failure. The authors of a study reported in the April 24, 1991 issue of The Journal of the American Medical Association suggested that perhaps the children's illnesses caused them to produce quantities of the protein interferon, which inhibited the vaccine's ability to produce immunity. However, measles vaccine is generally given in conjunction with mumps and rubella (German measles) vaccines, and these are generally effective, even when the children have respiratory infections. Since interferon has a broad spectrum of activity, it would be expected that the children who did not respond to measles vaccine should not respond to mumps or rubella, if interferon was the cause of the vaccine failure. Given that 79 percent of the children with upper respiratory illnesses did develop immunity to measles with vaccination, the vaccine should continue to be given to children on schedule, with a second dose given at a later date to ensure protection. (Consumer Summary produced by Reliance Medical Information, Inc.)