Viral respiratory infections in patients with chronic non-specific lung disease (CNSLD)
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It is a well known clinical phenomenon that patients suffering from bronchial obstructive disorders, usually covered by the term chronic non-specific lung disease (CNSLD) tend to react with exacerbations of their disease in the course of respiratory infections, especially if a viral or mycoplasmal agent is involved. However, there is no uniform opinion about the relative importance of viral respiratory infections in this respect, and much of the background of the features observed in virus-induced exacerbations is still unknown. This is at least partly due to semantic uncertainty with regard to both respiratory infection and the various clinical entities encompassed by the spectrum of CNSLD. The term CNSLD covers conditions most commonly referred to as bronchial asthma, asthmatic bronchitis, chronic bronchitis, and pulmonary emphysema. The Netherlands Asthma Centre in Davos, Switzerland, lS a clinic for treatment of Dutch CNSLD patients. It is situated 1560 m above sea leve~ where climatic conditions have been shown to affect the course of the bronchial obstructive disease in a favourable way. Patients are usually referred to the clinic for a period of at least several months. In 1975 the suggestion was put forward that the situation in theDavos clinic was highly suitable to investigate some aspects of the abovementioned relationship between respiratory viral infection and flare-ups of signs and symptoms of CNSLD. A 4-year study was designed in order to find an answer to the following questions: I. Which is the frequency of symptomatic respiratory infection (SRI) in a group of CNSLD patients during their stay in an alpine climate? 2. In how many episodes of SRI can a viral or mycoplasmal agent be identified as a causative factor, doing systemically conducted serological investigations? 3. To which extent do respiratory infections of known and unknownorigin cause exacerbations of CNSLD?