Most parents of toddlers are all too familiar with otitis media (OM), more commonly referred to as an ear infection. According to the National Institute on Deafness and Other Communication Disorders, 75% of children experience at least one episode of otitis media by their third birthday. The medical costs to treat otitis media and lost wages due to the disease are enormous. Ear infections are the number one reason children are taken to the pediatrician.

Otitis media is an infection or inflammation in the middle ear that occurs in one of two ways. The first, an acute ear infection, is accompanied by pain and fever. This is most prevalent during winter months, when upper respiratory virus infection (the common cold) is widespread among infants and young children. The common cold often causes inflammation and swelling of the Eustachian tube, which connects the middle ear cavity to the nose and throat. Poor Eustachian tube function creates a high negative pressure in the middle ear, which promotes entry of resident bacteria to the middle ear cavity. These bacteria cause an acute infection (inflammation), resulting in pain, fever and fluid accumulation in the middle ear.

The second instance, otitis media with effusion (OME), is the accumulation of fluid in the middle ear space without symptoms of an acute ear infection. This generally follows treatment of an acute ear infection with antibiotics. Evidence suggests that when dead bacteria or bacterial components remain in the middle ear, these bacterial toxins can cause and sustain chronic inflammation and fluid accumulation. Unlike children with an acute ear infection, children with OME are not sick. Because there are no symptoms, this condition can go unnoticed. Parents may find the TV volume is too loud or a teacher may see that the child is not paying attention in class.

The major risk factors for contracting otitis media include exposure to the common cold through contact with other children in preschool and day care facilities, second-hand smoke, allergies and some birth defects. However, the primary risk factor is a family history of otitis media. If otitis media runs in a child’s family, that child is five times more likely to be susceptible to the disease. Most children outgrow the tendency to develop otitis media by the time they are seven or eight years old. Antibiotics are still a common treatment.

“We do not fully understand the interaction of the bacteria with the host in otitis media,” said OM expert, David Lim, M.D. “Our research is focused on how bacteria interact with the host cell in the middle ear. We are trying to identify the natural defense mechanisms that enable the ear to fight off infection.” Dr. Lim is hopeful that his research results may lead to a non-antibiotic treatment for otitis media.