What’s normal in children’s respiratory infections? Bristol parents helped us find out


by Dr Emma Anderson
Senior Research Associate
Centre for Academic Primary Care

As any parent knows, children get coughs, colds and ear infections all the time. Symptoms of these respiratory infections – including runny nose, cough and sore throat – can seem never-ending.

In the EEPRIS Study, led by Professor Alastair Hay from the University of Bristol’s Centre for Academic Primary Care, we recruited parents across Bristol to tell us about their children’s respiratory symptoms as they became ill. Gathering information in the community means we are able to find out more about common respiratory illnesses than when we study those who have decided to consult their GP. It also gives us a more accurate picture of how likely parents are to consult for these common illnesses, something which has been surprisingly unclear.

Two of our main findings were that:

  • it takes up to three weeks for most children’s respiratory infections to resolve
  • about one in twelve children who develop a respiratory infection see their GP

What we did – novel community research

Most research in this area has looked at respiratory infections in children who see their GP. Our study was novel in that we followed children out in the community, tracking them from their first noticeable respiratory symptom. We achieved this because of the willingness of Bristol parents to record their children’s symptoms online as they developed.

In total, 331 parents with 485 children took part in the study, reporting symptoms of 346 new respiratory infections that developed between February and July 2016 via (email prompted) online surveys. We were initially unsure of how this project would be received, and so we were delighted to find local parents and children were so willing to get involved. We are very grateful to all the families that made this possible.

Duration of symptoms – younger children have longer illnesses

The data showed us that it took 23 days for 90 per cent of children to recover from all symptoms. Overall, the average (median) duration of symptoms for any respiratory infection was nine days. The youngest children (aged up to 3 years old) had longer illnesses, with an average (median) symptom duration of 11 days compared to 7 days for the older children (aged 4+). It is important to be aware of this difference as parents and clinicians tend to worry more about illnesses in very young children, and lengthy symptoms can be a cause for worry.

Type of symptoms makes a difference

We also found that when a parent reported any chesty symptoms, such as a wet cough and wheeze, the illness lasted longer (an average of 12 days) than those with only upper respiratory infection symptoms, such as a runny nose and sore throat (average 8 days). Among upper respiratory symptoms, runny nose was the most persistent and earache was the fastest to resolve.

Why is this important?

Our findings will be useful for parents to know what to expect in these common illnesses in their children, which could help them know whether to consult their GP or not. This knowledge can also help GPs and public health professionals give general advice to parents about the normal course of respiratory infections, including when to consult. It may also have a role in helping reduce unnecessary antibiotic prescribing.

The study was published in Annals of Family Medicine and was funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Evaluation of Interventions.

Paper: Respiratory tract infections in children in the community: prospective online inception cohort study. Alastair D Hay et al. Annals of Family Medicine.

Further information

About the Centre for Academic Primary Care

The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching. Follow us on Twitter: @capcbristol.

About the NIHR Health Protection Research Unit in Evaluation of Interventions

The Health Protection Research Unit (HPRU) in Evaluation of Interventions, based in Population Health Sciences at the University of Bristol, is part of the National Institute for Health Research and a partnership between University of Bristol and Public Health England (PHE), in collaboration with University College London, Cambridge MRC Biostatistics Unit and University of the West of England. We are a multidisciplinary team undertaking applied research on the development and evaluation of interventions to protect the public’s health. Our aim is to support PHE in delivering its objectives and functions. Our focus is on the PHE priority area of infection.  Follow us on Twitter: @HPRU_EI.

About the National Institute for Health Research

The National Institute for Health Research (NIHR) is the nation’s largest funder of health and care research. The NIHR:

  • funds, supports and delivers high quality research that benefits the NHS, public health and social care
  • engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
  • attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
  • invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
  • partners with other public funders, charities and industry to maximise the value of research to patients and the economy.

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR commissions applied health research to benefit the poorest people in low- and middle-income countries, using Official Development Assistance funding.

This work uses data provided by patients and collected by the NHS as part of their care and support and would not have been possible without access to this data. The NIHR recognises and values the role of patient data, securely accessed and stored, both in underpinning and leading to improvements in research and care. www.nihr.ac.uk/patientdata


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