Human rhinovirus C associated with wheezing in hospitalised children in the Middle East.
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.
Miller
E Kathryn
EK
Department of Pediatrics, Vanderbilt University, Nashville, TN, USA. eva.k.miller@vanderbilt.edu
Khuri-Bulos
Najwa
N
Williams
John V
JV
Shehabi
Asem A
AA
Faouri
Samir
S
Al Jundi
Ihsan
I
Chen
Qingxia
Q
Heil
Luke
L
Mohamed
Yassir
Y
Morin
Laura-Lee
LL
Ali
Asad
A
Halasa
Natasha B
NB
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
D012367:RNA, Viral; D015678:Viral Structural Proteins