Rhinovirus

Virology

Types: there are over 100 serotypes

  • Rhinovirus A
  • Rhinovirus B
  • Rhinovirus C

Physiology

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  • Viral Shedding: shedding of rhinovirus can extend for >2 wks after infection

    • This makes it difficult it interpret the detection of rhinovirus in the setting of pneumonia

Diagnosis

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Clinical Manifestations

Otolaryngologic Manifestations

Pulmonary Manifestations

Increased Risk of Future Asthma (see Asthma, [[Asthma]])

  • Epidemiology: wheezing from rhinovirus infection from birth-3 y/o increased odds ratio to 9.8 of developing asthma by age 6 (the odds ratio increased to 10.0 in presence of both RSV and rhinovirus-related wheezing illnesses from birth-3 y/o) [MEDLINE]

Pneumonia (see Pneumonia, [[Pneumonia]])

  • Epidemiology
    • Studies support the role of rhinovirus as a sole or synergistic pathogen in pneumonia [MEDLINE] [MEDLINE] [MEDLINE]
    • CDC EPIC Study of Children Hospitalized for Community-Acquired Pneumonia (2015) [MEDLINE]
      • Annual Incidence of Community-Acquired Pneumonia Requiring Hospitalization: 15.7 cases per 10k children <18 y/o
      • A pathogen was identified in 81% of cases
      • Rhinovirus was detected in 27% of cases (RSV was the common pathogen identified, being detected in 28% of cases)
        • However, rhinovirus was detected in 17% of control patients in this study (compared with 22% of children with pneumonia enrolled at the same study sites during the same period)

Other Manifestations

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References

  • Rhinovirus and the lower respiratory tract. Rev Med Virol 2004;14: 17-31 [MEDLINE]
  • Wheezing Rhinovirus Illnesses in Early Life Predict Asthma Development in High-Risk Children. Am J Respir Crit Care Med. 2008 October 1; 178(7): 667–672 [MEDLINE]
  • Human rhinovirus species associated with hospitalizations for acute respiratory illness in young US children. J Infect Dis 2011;204:1702-10 [MEDLINE]
  • Human rhinovirus infections in rural Thailand: epidemiological evidence for rhinovirus as both pathogen and bystander. PloS One 2011;6(3):e17780 [MEDLINE]
  • Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015 Feb 26;372(9):835-45. doi: 10.1056/NEJMoa1405870 [MEDLINE]