Asia Pac Allergy.  2016 Jul;6(3):157-163. 10.5415/apallergy.2016.6.3.157.

Relationship between all fevers or fever after vaccination, and atopy and atopic disorders at 18 and 36 months

• Wong HH
• Lee JJ
• Shek LP
• Lee BW
• Goh A
• Teoh OH
• Gluckman P
• Godfrey KM
• Saw SM
• Kwek K
• Chong YS
• Van Bever

• KMID: 2400416
• DOI: http://doi.org/10.5415/apallergy.2016.6.3.157

Abstract

BACKGROUND
Studies have reported that early febrile episodes and febrile episodes with infections are associated with a decreased risk of developing atopy.
OBJECTIVE
To examine further the association between presence of and number of febrile episodes are with atopy and atopic diseases and if there was a difference between all fevers and fever after vaccination.
METHODS
We studied 448 infants in a Singapore mother-offspring cohort study (Growing Up in Singapore Towards Healthy Outcomes) which had complete data for the exposures and outcomes of interest. Fever was defined as more than 38.0℃ and was self-reported. The presence of and number of febrile episodes were examined for association with outcome measures, namely parental reports of doctor-diagnosed asthma and eczema, and rhinitis, which was evaluated by doctors involved in the study at 18 and 36 months. These outcomes were considered atopic if there were 1 or more positive skin prick tests.
RESULTS
The presence of all fevers from 0-6 months of age was associated with reduced odds of having atopy at 36 months of age (unadjusted odds ratio [OR], 0.628; 95% confidence interval [CI], 0.396-0.995). The presence of fever after vaccination from 0-24 months of age was associated with reduced odds of having atopy at 36 months of age (OR, 0.566; 95% CI, 0.350-0.915). The presence of all fevers from 0-6 months of age was associated with reduced odds of having atopic eczema at 36 months (OR, 0.430; 95% CI, 0.191-0.970). Fever was associated with increased odds of having doctor-diagnosed asthma and rhinitis.
CONCLUSION
There was an inverse relationship between the presence of all fevers from 0-6 months of age and the development of atopy and eczema at 36 months of age. Fever after vaccination might be considered a subclinical infection that did not show the same effect in early life.

Keyword

Asthma; Eczema; Fever; Rhinitis

MeSH Terms

Asthma
Asymptomatic Infections
Cohort Studies
Dermatitis, Atopic
Eczema
Fever*
Humans
Infant
Odds Ratio
Outcome Assessment (Health Care)
Parents
Rhinitis
Singapore
Skin
Vaccination*

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