Molecular characterization and distinguishing features of a novel human rhinovirus (HRV) C, HRVC-QCE, detected in children with fever, cough and wheeze during 2003.
BACKGROUND
Human rhinoviruses (HRVs) are associated with more acute respiratory tract infections than any other viral group yet we know little about viral diversity, epidemiology or clinical outcome resulting from infection by strains, in particular the recently identified HRVs.


OBJECTIVE
To determine whether HRVC-QCE was a distinct HRV-C strain, by determining its genome and prevalence, by cataloguing genomic features for strain discrimination and by observing clinical features in positive patients.


METHODS
Novel real-time RT-PCRs and retrospective chart reviews were used to investigate a well-defined population of 1247 specimen extracts to observe the prevalence and the clinical features of each HRV-QCE positive case from an in- and out-patient pediatric, hospital-based population during 2003. An objective illness severity score was determined for each HRVC-QCE positive patient.


RESULTS
Differences in overall polyprotein and VP1 binding pocket residues and the predicted presence of a cis-acting replication element in 1B defined HRVC-QCE as a novel HRV-C strain. Twelve additional HRVC-QCE detections (1.0% prevalence) occurred among infants and toddlers (1-24 months) suffering mild to moderate illness, including fever and cough, who were often hospitalized. HRVC-QCE was frequently detected in the absence of another virus and was the only virus detected in three (23% of HRVC-QCE positives) children with asthma exacerbation and in two (15%) toddlers with febrile convulsion.


CONCLUSIONS
HRVC-QCE is a newly identified, genetically distinct HRV strain detected in hospitalized children with a range of clinical features. HRV strains should be independently considered to ensure we do not overestimate the HRVs in asymptomatic illness.
Arden
K E
KE
Sir Albert Sakzewski Virus Research Centre, Queensland Children's Medical Research Institute, Royal Children's Hospital, Queensland, Australia.
Faux
C E
CE
O'Neill
N T
NT
McErlean
P
P
Nitsche
A
A
Lambert
S B
SB
Nissen
M D
MD
Sloots
T P
TP
Mackay
I M
IM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000595:Amino Acid Sequence; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003371:Cough / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D010850:Picornaviridae Infections / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics*; D012135:Respiratory Sounds / Q000209:etiology; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012229:Rhinovirus / Q000145:classification* / Q000302:isolation & purification*; D017422:Sequence Analysis, DNA; D017385:Sequence Homology; D055815:Young Adult
D012367:RNA, Viral