Otitis Media is a significant disease of children characterized by the presence of inflammation and fluid in the middle ear. For persistent cases, current methods of treatment are often unsuccessful in resolving the middle ear inflammation. Therefore, the development of prevention strategies represents a primary goal of current research. The results of past studies show that more than 50% of the new episodes of otitis media are temporally associated with a viral upper respiratory tract infection. Thus, prevention of otitis media could be accomplished by preventing or successfully treating the underlying virus infection. However, to date the feasibility of this strategy has not been tested and clinical trials of this option in children are subject to ethical concerns related to possible side-effects of the candidate therapies. Previously, we developed experimental respiratory virus challenges in adults as a model to study the otologic complications of those infections. We reported that influenza A virus infection causes eustachian tube dysfunction (80%), middle ear underpressures (70%) and otitis media (20%) in adults. Others reported that oral amantadine or ramantadine treatment is effective for decreasing the duration of signs and symptoms in patients with influenza A infection. In the proposed study, we plan to investigate whether ramantadine given during an experimental influenza A virus infection in adults moderates the otologic expression of that disease. The results will be used to develop further this experimental model for use as a screening tool in evaluating the efficacy of new and promising antivirals (or inflammatory mediator antagonists) and to define the feasibility of using antiviral agents for preventing otitis media during a respiratory virus infection.
