title: Prolonged shedding of rhinovirus and re-infection in adults with respiratory tract illness.
abstract: Rhinovirus infections occur frequently throughout life and have been reported in about one-third of asymptomatic cases. The clinical significance of sequential rhinovirus infections remains unclear. To determine the incidence and clinical relevance of sequential rhinovirus detections, nasopharyngeal samples from 2485 adults with acute cough/lower respiratory illness were analysed. Patients were enrolled prospectively by general practitioners from 12 European Union countries during three consecutive years (2007-2010). Nasopharyngeal samples were collected at the initial general practitioner consultation and 28 days thereafter and symptom scores were recorded by patients over that period. Rhinovirus RNA was detected in 444 (18%) out of 2485 visit one samples and in 110 (4.4%) out of 2485 visit two respiratory samples. 21 (5%) of the 444 patients had both samples positive for rhinovirus. Genotyping of both virus detections was successful for 17 (81%) out of 21 of these patients. Prolonged rhinovirus shedding occurred in six (35%) out of 21 and re-infection with a different rhinovirus in 11 (65%) out of 21. Rhinovirus re-infections were significantly associated with chronic obstructive pulmonary disease (p=0.04) and asthma (p=0.02) and appeared to be more severe than prolonged infections. Our findings indicate that in immunocompetent adults rhinovirus re-infections are more common than prolonged infections, and chronic airway comorbidities might predispose to more frequent rhinovirus re-infections.
authors.affiliation: Dept of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands kalina.zlateva@gmail.com.
authors.forename: Kalina T
authors.initials: KT
authors.lastname: Zlateva
authors.affiliation: Dept of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jutte J C
authors.initials: JJ
authors.lastname: de Vries
authors.affiliation: Dept of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Frank E J
authors.initials: FE
authors.lastname: Coenjaerts
authors.affiliation: Dept of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Anton M
authors.initials: AM
authors.lastname: van Loon
authors.affiliation: Dept of Data management, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Theo
authors.initials: T
authors.lastname: Verheij
authors.affiliation: University of Southampton Medical School, Primary Care Medical Group, Southampton, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Little
authors.affiliation: Dept of Primary Care Sciences, Oxford University, Oxford, UK.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Butler
authors.affiliation: Dept of Medical Microbiology, Vaccine and Infectious Disease Institute, University Hospital Antwerp, Antwerp, Belgium.
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
authors.affiliation: Dept of Medical Microbiology, Vaccine and Infectious Disease Institute, University Hospital Antwerp, Antwerp, Belgium.
authors.forename: Margareta
authors.initials: M
authors.lastname: Ieven
authors.affiliation: Dept of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Eric C J
authors.initials: EC
authors.lastname: Claas
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000150:complications; D015897:Comorbidity; D024882:Drug Resistance, Viral; D005062:European Union; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D058889:Molecular Typing; D010850:Picornaviridae Infections / Q000453:epidemiology / Q000821:virology*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000821:virology*; D012229:Rhinovirus; D016896:Treatment Outcome; D017201:Virus Shedding; D055815:Young Adult