title: Human rhinovirus C associated with wheezing in hospitalised children in the Middle East.
abstract: BACKGROUND
  Few studies have investigated the disease burden and genetic diversity of human rhinoviruses (HRVs) in developing countries.
  
  
  OBJECTIVE
  To assess the burden of HRV in Amman, Jordan, and to characterise clinical differences between HRV groups.
  
  
  METHODS
  We prospectively studied children <5 years, hospitalised with respiratory symptoms and/or fever in Amman, Jordan. Viruses were identified by real-time reverse transcriptase polymerase chain reaction (RT-PCR). VP4/VP2 gene sequencing was performed on HRV-positive specimens.
  
  
  RESULTS
  Of the 728 enrolled children, 266 (37%) tested positive for picornaviruses, 240 of which were HRV. Of the HRV-positive samples, 62 (26%) were of the recently identified group HRVC, 131 (55%) were HRVA and seven (3%) were HRVB. The HRVC strains clustered into at least 19 distinct genotypes. Compared with HRVA-infected children, children with HRVC were more likely to require supplemental oxygen (63% vs. 42%, p=0.007) and, when co-infections were excluded, were more likely to have wheezing (100% vs. 82%, p=0.016).
  
  
  CONCLUSIONS
  There is a significant burden of HRV-associated hospitalisations in young children in Jordan. Infection with the recently identified group HRVC is associated with wheezing and more severe illness.
authors: Department of Pediatrics, Vanderbilt University, Nashville, TN, USA. eva.k.miller@vanderbilt.edu
authors: E Kathryn
authors: EK
authors: Miller
authors: Najwa
authors: N
authors: Khuri-Bulos
authors: John V
authors: JV
authors: Williams
authors: Asem A
authors: AA
authors: Shehabi
authors: Samir
authors: S
authors: Faouri
authors: Ihsan
authors: I
authors: Al Jundi
authors: Qingxia
authors: Q
authors: Chen
authors: Luke
authors: L
authors: Heil
authors: Yassir
authors: Y
authors: Mohamed
authors: Laura-Lee
authors: LL
authors: Morin
authors: Asad
authors: A
authors: Ali
authors: Natasha B
authors: NB
authors: Halasa
mesh_terms: D002675:Child, Preschool; D016000:Cluster Analysis; D005260:Female; D005334:Fever / Q000209:etiology; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007597:Jordan / Q000453:epidemiology; D008297:Male; D008969:Molecular Sequence Data; D010850:Picornaviridae Infections / Q000453:epidemiology / Q000503:physiopathology* / Q000821:virology*; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D012135:Respiratory Sounds / Q000209:etiology*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D012229:Rhinovirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D017422:Sequence Analysis, DNA; D015678:Viral Structural Proteins / Q000235:genetics
chemical_list: D012367:RNA, Viral; D015678:Viral Structural Proteins