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        • » Viral Interactions and AOM Bacterial Load: A Longitudinal Evaluation (VIABLE)

Viral Interactions and AOM Bacterial Load: A Longitudinal Evaluation (VIABLE)



The VIABLE study was an investigation into whether respiratory viruses explained high rates of acute otitis media with perforation (AOMwiP) in young Aboriginal children in remote Australia. The study took the form of a retrospective analysis of clinical trial specimens and data. It used stored nasopharyngeal swabs collected at monthly visits from children less than 18 months of age with AOM with perforation and from children without AOM to determine the prevalence of respiratory viruses (influenza A and B; respiratory syncytial virus; parainfluenza 1,2 & 3; rhinovirus, adenovirus, human metapneumovirus). The AOM-pathogen-specific load (Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis) was quantified, as was total bacterial load prior to and at the time of perforation. Mathematical models of bacterial load and viral infection were applied to test the hypothesis that viral infection directly or indirectly increases the risk of AOMwiP.

The study confirmed a positive association between nasopharyngeal bacterial load and clinical ear state, exacerbated by respiratory viruses, in Indigenous children. Adenovirus (HAdV) was independently associated with acute ear states.


Dr Amanda Leach
Child Health Division
Menzies School of Health Research
PO Box 41096
Casurina NT 0811
Ph: (08) 8922 8196
Fax: (08) 8927 5187

Related publications

Binks MJ, Cheng AC, Smith-Vaughan H, Sloots T, Nissen M, Whiley D, McDonnell J, Leach AJ (2011)

Viral-bacterial co-infection in Australian Indigenous children with acute otitis media.

BMC Infectious Diseases; 11: 161

Retrieved 7 June 2011 from


Last updated: 13 September 2016
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