Epidemiologic Findings Suggesting Transmissibility

The family pattern of atopy has led to the assumption that atopy is primarily a genetic predisposition. Infectious diseases to which the very young are most susceptible also have a family pattern. As in atopy, some sporadic cases develop outside the family situation. That genes play a part in susceptibility is not incompatible with the kinds of viruses that could be responsible for atopy. The presence of atopy rates as high as 40% among individuals of various races in places like Australia suggests that if a virus is involved, genetic permissiveness must be common.

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The greatest risk for atopy in infancy and young childhood is asthma or atopic disease in first-degree relatives, especially in an asthmatic mother. At least 80% of childhood asthma and all allergic rhinitis is atopic, so atopy can be assumed for most cases of asthma in the Tucson Children’s Respiratory Study. In that study, the risk stemming from maternal asthma was 44.2% compared with the risk from paternal asthma (31.4%; p > 0.05). Allergic rhinitis in either parent was a risk factor for asthma in the child, but when analysis was confined to children without asthmatic parents, only allergic rhinitis in the mother remained a significant risk factor for asthma in the child.