Epidemiologic, clinical, and virologic characteristics of human rhinovirus infection among otherwise healthy children and adults: rhinovirus among adults and children.
BACKGROUND
human rhinovirus (HRV) is a major cause of influenza-like illness (ILI) in adults and children. Differences in disease severity by HRV species have been described among hospitalized patients with underlying illness. Less is known about the clinical and virologic characteristics of HRV infection among otherwise healthy populations, particularly adults.


OBJECTIVE
to characterize molecular epidemiology of HRV and association between HRV species and clinical presentation and viral shedding.


METHODS
observational, prospective, facility-based study of ILI was conducted from February 2010 to April 2012. Collection of nasopharyngeal specimens, patient symptoms, and clinical information occurred on days 0, 3, 7, and 28. Patients recorded symptom severity daily for the first 7 days of illness in a symptom diary. HRV was identified by RT-PCR and genotyped for species determination. Cases who were co-infected with other viral respiratory pathogens were excluded from the analysis. We evaluated the associations between HRV species, clinical severity, and patterns of viral shedding.


RESULTS
eighty-four HRV cases were identified and their isolates genotyped. Of these, 62 (74%) were >18 years. Fifty-four were HRV-A, 11HRV-B, and 19HRV-C. HRV-C infection was more common among children than adults (59% vs. 10%, P<0.001). Among adults, HRV-A was associated with higher severity of upper respiratory symptoms compared to HRV-B (P=0.02), but no such association was found in children. In addition, adults shed HRV-A significantly longer than HRV-C (P trend=0.01).


CONCLUSIONS
among otherwise healthy adults with HRV infection, we observed species-specific differences in respiratory symptom severity and duration of viral shedding.
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Wei-Ju
WJ
Chen
Naval Medical Center, San Diego, CA, USA.
John C
JC
Arnold
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Madigan Army Medical Center, Tacoma, WA, USA.
Mary P
MP
Fairchok
Defense Institute for Medical Operations, San Antonio, TX, USA.
Patrick J
PJ
Danaher
Naval Health Research Center, San Diego, CA, USA.
Erin A
EA
McDonough
Naval Health Research Center, San Diego, CA, USA.
Patrick J
PJ
Blair
Naval Medical Research Unit No. 6, Lima, Peru.
Josefina
J
Garcia
Naval Medical Research Unit No. 6, Lima, Peru.
Eric S
ES
Halsey
Madigan Army Medical Center, Tacoma, WA, USA.
Christina
C
Schofield
Office of Curriculum, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Martin
M
Ottolini
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Deepika
D
Mor
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Michelande
M
Ridoré
Walter Reed National Military Medical Center, Bethesda, MD, USA.
Timothy H
TH
Burgess
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. Electronic address: emillar@idcrp.org.
Eugene V
EV
Millar
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D010802:Phylogeny; D010850:Picornaviridae Infections / Q000453:epidemiology* / Q000821:virology*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000821:virology*; D012229:Rhinovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D017422:Sequence Analysis, DNA; D017201:Virus Shedding; D055815:Young Adult
HRV genotypes; Military; Rhinovirus; Viral shedding