Ear infection

What is an ear infection?

Otitis externa (also known as 'swimmer's ear') leads to the inflammation of the skin of the external ear. Exposure to water (swimming), picking the ear and cleaning the ear with cotton buds or matches and cosmetic products (shampoo, soap or hair spray) can result in the irritation of the skin in the ear canal and therefore inflammation. Wearing an earphone or a hearing aid can also irritate the ear canal. A narrow ear canal, as in people with Down syndrome, results in a higher risk of infection. Otitis externa is more common in people with conditions such as eczema, psoriasis or allergy. The cause is usually a bacterial or fungal infection. The inflammation will usually be gone after one to two weeks.

In otitis media, the ear is inflamed in the middle ear behind the eardrum. The inflammation often begins with a simple cold before spreading to the ear. The build-up of fluid in the middle ear causes painful pressure on the eardrum. The pressure can sometimes cause the eardrum to rupture and allow the fluid to run out of the ear. This rupture will usually heal without intervention. The most severe symptoms will usually subside within three days. However, hearing may be affected for a while.

What are the complaints associated with an ear infection?

Otitis externa causes pain, itching or a burning sensation. The skin flakes, the ear canal is swollen and there may be a discharge of fluid, which may cause hearing to be affected for a while.

Otitis media causes ear pain, fever and general malaise. Children may also have stomach ache, diarrhoea or vomiting. In some cases, fluid, sometimes containing a small amount of blood, may flow out of the ear.

People with intellectual disabilities sometimes find it impossible to communicate symptoms such as pain and itching. The people around them may then notice only a change in behaviour.

How common are ear infections in the general population?

Otitis externa is mainly seen in adults. The average one-year prevalence is 1.7%. ⁵⁰⁹

Otitis media is a condition that primarily affects children. The average one-year prevalence is 4.5%. Frequency declines with age. ⁵⁰⁹

How common are ear infections in people with intellectual disabilities?

This is not known for the general population.

People with Down syndrome are prone to middle ear infections due to the inadequate functioning of the Eustachian tube. ¹⁹⁹

Children with Down syndrome have a very much higher risk of otitis media with effusion (a runny ear): 52%, peaking between the first and sixth or seventh year of life, when it is seen in approximately 60% of these children. ⁵¹⁰

People with Down syndrome have narrow ear canals, as a result of which earwax accumulates in the ear canal. In addition, many of these children have eczema in the ear canal, resulting in the accumulation of dead skin cells, the impairment of the self-cleaning mechanism of the ear canal, and an increase in the risk of infection. ²⁰⁰  
1.7% to 4.5% General population Not known for people with intellectual disabilities