Cockroach and other inhalant allergies in infantile asthma

Background: Infantile asthma is commonly thought to be caused by viral resp iratory infections and exposure to second-hand cigarette smoke. Allergy has not been felt to be a major cause of infantile asthma and infants and smal l children are not commonly skin tested. Objective: To determine the frequency of skin test reactivity in asthmatic children less than 3 years of age. Methods: We evaluated 196 (5 female/146 male) children with infantile asthm a for allergy. Infantile asthma was defined as three or more episodes of wh eezing in a child less than 3 years of age. A careful environmental history was obtained on all children. All were skin tested to alternaria, cat, dog , cockroach, and house dust mites (HDM) extracts using the prick technique with the Greer Dermapik. Results: Forty-five percent of the infants and children tested had at least one positive skin test. 51/196 (26%) of the children were skin test positi ve to cockroach, 17.3% to HDM, 13.8% to cat, 6.6% to alternaria, and 6.1% p ositive to dog. For the 49 children who were less than 1 year of age, 28.5% were positive to cockroach, 10.2% to HDM, 10.2% to cats, 4% to alternaria, and 0% to dog. Conclusions: Allergy to cockroach and other indoor allergens may be a signi ficant contributor to infantile asthma in a rural setting. Skin testing chi ldren with infantile asthma may provide useful information for institution of environmental controls measures in the child's home.