Upper respiratory tract infection may be a frequent precipitating factor for OME (and acute otitis media [AOM]).[2]Rosenfeld RM, Shin JJ, Schwartz SR, et al. Clinical practice guideline: otitis media with effusion (update). Otolaryngol Head Neck Surg. 2016 Feb;154(1 suppl):S1-41.
https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1177/0194599815623467
http://www.ncbi.nlm.nih.gov/pubmed/26832942?tool=bestpractice.com
Mucosal inflammation secondary to infection can lead to obstruction and dysfunction of the Eustachian tubes, thereby leading to fluid accumulation within the middle ear.[11]Bluestone CD. Pathogenesis of otitis media: role of eustachian tube. Pediatr Infect Dis J. 1996 Apr;15(4):281-91.
http://www.ncbi.nlm.nih.gov/pubmed/8866795?tool=bestpractice.com
Prevention of upper respiratory tract infections may therefore prevent OME (and AOM).
The pneumococcal conjugate and influenza vaccines are recommended to prevent pneumococcal- and influenza-related illnesses, which may in turn prevent AOM and as such, secondary OME.[42]Grohskopf LA, Blanton LH, Ferdinands JM, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices - United States, 2022-23 influenza season. MMWR Recomm Rep. 2022 Aug 26;71(1):1-28.
https://www.cdc.gov/mmwr/volumes/71/rr/rr7101a1.htm?s_cid=rr7101a1_w
http://www.ncbi.nlm.nih.gov/pubmed/36006864?tool=bestpractice.com
[43]Centers for Disease Control and Prevention. Pneumococcal ACIP vaccine recommendations. Jan 2022 [internet publication].
https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/pneumo.html
[44]Clements DA, Langdon L, Bland C, et al. Influenza A vaccine decreases the incidence of otitis media in 6- to 30-month-old children in day care. Arch Pediatr Adolesc Med. 1995 Oct;149(10):1113-7.
http://www.ncbi.nlm.nih.gov/pubmed/7550814?tool=bestpractice.com
[45]Marchisio P, Cavagna R, Maspes B, et al. Efficacy of intranasal virosomal influenza vaccine in the prevention of recurrent acute otitis media in children. Clin Infect Dis. 2002 Jul 15;35(2):168-74.
https://academic.oup.com/cid/article/35/2/168/398581
http://www.ncbi.nlm.nih.gov/pubmed/12087523?tool=bestpractice.com
[46]Ozgur SK, Beyazova U, Kemaloglu YK, et al. Effectiveness of inactivated influenza vaccine for prevention of otitis media in children. Pediatr Infect Dis J. 2006 May;25(5):401-4.
http://www.ncbi.nlm.nih.gov/pubmed/16645502?tool=bestpractice.com
Details on current vaccination schedules and special patient populations can be found in the latest CDC Advisory Committee on Immunization Practices (ACIP) vaccination schedule.
CDC: ACIP recommendations
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Avoidance of tobacco smoke exposure may also decrease the risk of OME. One meta-analysis found that second-hand smoke exposure was significantly associated with increased odds of middle ear disease, although the heterogeneity among the included studies was high.[47]Jones LL, Hassanien A, Cook DG, et al. Parental smoking and the risk of middle ear disease in children: a systematic review and meta-analysis. Arch Pediatr Adolesc Med. 2012 Jan;166(1):18-27.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/1107682
http://www.ncbi.nlm.nih.gov/pubmed/21893640?tool=bestpractice.com
In adults, an association was found between tobacco smoking and chronic suppurative otitis media, with mixed evidence.[48]Gaur K, Kasliwal N, Gupta R. Association of smoking or tobacco use with ear diseases among men: a retrospective study. Tob Induc Dis. 2012 Apr 3;10(1):4.
https://tobaccoinduceddiseases.biomedcentral.com/articles/10.1186/1617-9625-10-4
http://www.ncbi.nlm.nih.gov/pubmed/22471960?tool=bestpractice.com
[49]Wang J, Chen B, Xu M, et al. Etiological factors associated with chronic suppurative otitis media in a population of Han adults in China. Acta Otolaryngol. 2016 Oct;136(10):1024-8.
http://www.ncbi.nlm.nih.gov/pubmed/27206699?tool=bestpractice.com
Daycare attendance is a risk factor for recurrent AOM and OME.[33]Todberg T, Koch A, Andersson M, et al. Incidence of otitis media in a contemporary Danish national birth cohort. PLoS One. 2014;9(12):e111732.
https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25545891
http://www.ncbi.nlm.nih.gov/pubmed/25545891?tool=bestpractice.com
[10]Zhang Y, Xu M, Zhang J, et al. Risk factors for chronic and recurrent otitis media-a meta-analysis. PLoS One. 2014;9(1):e86397.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900534
http://www.ncbi.nlm.nih.gov/pubmed/24466073?tool=bestpractice.com
This is likely related to increased exposure to viral pathogens, which cause upper respiratory tract infections. If feasible for the family, taking a child out of daycare may prevent both AOM and OME.