Rhino virus common cold


















A diverse group of previously unrecognized human rhinoviruses are common causes of respiratory illnesses in infants.

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Phylogenetic analysis of rhinovirus isolates collected during successive epidemic seasons. Virus Res. Human rhinovirus C: Age, season, and lower respiratory illness over the past 3 decades J Allergy Clin Immunol 1 69— Community-wide, contemporaneous circulation of a broad spectrum of human rhinoviruses in healthy Australian preschool-aged children during a month period. Detection of multiple respiratory pathogens during primary respiratory infection: nasal swab versus nasopharyngeal aspirate using real-time polymerase chain reaction.

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Rhinoviruses are a major cause of wheezing and hospitalization in children less than 2 years of age. Detection of viruses identified recently in children with acute wheezing. Wheezing rhinovirus illnesses in early life predict asthma development in high-risk children. Rhinovirus illnesses during infancy predict subsequent childhood wheezing. Updates in the relationship between human rhinovirus and asthma. Allergy Asthma Immunol Res.

Evidence for a causal relationship between allergic sensitization and rhinovirus wheezing in early life. Rhinovirus wheezing illness and genetic risk of childhood-onset asthma. N Engl J Med. Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease. Respiratory viruses in exacerbations of chronic obstructive pulmonary disease requiring hospitalisation: a case-control study.

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Detection of rhinovirus in sinus brushings of patients with acute community-acquired sinusitis by reverse transcription-PCR. Nose blowing propels nasal fluid into the paranasal sinuses.

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Respiratory viruses in neonates hospitalized with acute lower respiratory tract infections. Pediatr Int. However, people with weakened immune systems, asthma, or respiratory conditions may develop serious illness, such as bronchitis or pneumonia. Help reduce your risk of getting a cold by washing hands often with soap and water.

Viruses that cause colds can spread from infected people to others through the air and close personal contact. You can also get infected through contact with stool poop or respiratory secretions from an infected person.

This can happen when you shake hands with someone who has a cold, or touch a surface, like a doorknob, that has respiratory viruses on it, then touch your eyes, mouth, or nose. Practice good cough and sneeze etiquette: always cough and sneeze into a tissue or your upper shirt sleeve, completely covering your mouth and nose. There is no cure for a cold. To feel better, you should get lots of rest and drink plenty of fluids. Over-the-counter medicines may help ease symptoms but will not make your cold go away any faster.

Always read the label and use medications as directed. Talk to your doctor before giving your child nonprescription cold medicines, since some medicines contain ingredients that are not recommended for children. Learn more about symptom relief of upper respiratory infections, including colds. A recent Cochrane review included subjects from 13 randomized controlled trials in which all subjects began zinc therapy within 3 days of the onset of symptoms and continued treatment for at least 5 days Formulations included zinc sulfate tablets, zinc sulfate syrup, or zinc gluconate or zinc acetate lozenges.

The authors of that study found that zinc supplementation within 24 h of the onset of a cold was associated with significantly reduced symptom severity and duration.

Another systematic review and meta-analysis similarly showed a dose-dependent reduction in the duration of symptoms among subjects exposed to zinc However, the benefits were limited to adults, and zinc did not impact symptom severity. Significant trial heterogeneity and a lack of adequate blinding may contribute to the different conclusions of the reviews.

When utilized for prevention, zinc supplementation for at least 5 months was associated with reduced cold incidences, school absenteeism, and antibiotic prescriptions in children First-generation i.

However, neither the severity of other cold symptoms, including cough, nasal obstruction, and sore throat, nor the total symptom severity scores were significantly different between groups. A Cochrane review of 32 trials confirmed a mild effect of first-generation antihistamines on rhinorrhea and sneezing, but this benefit was not replicated with nonsedating antihistamines Furthermore, in clinical practice, their use is limited by side effects such as dry eyes, nose, and mouth.

Tremacamra, targeting recombinant soluble ICAM-1, and enviroxime, with an unknown mechanism, are two compounds evaluated for HRV prevention and treatment that failed to show a benefit in clinical trials. More information on these agents is available in Table 1. Potential modes of person-to-person HRV transmission include small-particle aerosols, large-particle aerosols 18 , and contact spread either directly or through a fomite 13 , Behavioral strategies to reduce respiratory viral transmission include social distancing, the use of respiratory masks, and hand hygiene.

Efforts to develop prophylactic medications and vaccinations specifically for HRV prevention have been unsuccessful. Behavioral strategies such as social distancing and respiratory mask application have been evaluated primarily in the context of pandemic influenza A virus and influenza-like illness prevention.

Social distancing includes school closures and the avoidance of public gatherings. An assessment of the effectiveness of social distancing in real-world settings is challenging due to the lack of randomization, inadequate reporting, and changing interventions over time , Broderick et al. They found that there was no significant difference in FRI rates between open and closed units; however, any effect of social distancing may have been mitigated by the finding that there was also considerable environmental pathogen contamination in the housing units.

Such studies highlight the complexity of systematic evaluations of population-based interventions in natural settings, rather than disprove their efficacy. The use of masks, particularly among health care workers, is an established effective intervention to reduce respiratory virus transmission It remains uncertain whether N95 respirators confer additional protection over surgical masks, and the degree of difference may vary by pathogen.

A well-designed randomized controlled trial designed to show noninferiority found that surgical masks offer protection similar to that of N95 respirators among nurses at the highest risk for exposure to influenza virus Hand-to-hand HRV transmission appears to be highly efficient, and individuals may also self-inoculate if a contaminated hand contacts nasal secretions.

Therefore, the interruption of direct contact in viral transmission presents a potential target for intervention. In a series of experiments with healthy volunteers challenged with HRV on the fingertips, Turner et al. In order to evaluate the efficacy of hand disinfection on HRV prevention in the natural setting, Turner et al.

In both the intention-to-treat and per-protocol analyses, there was no difference between treatment groups in the primary endpoint, HRV-associated illness, or the secondary endpoint, the incidence of HRV infection. Despite evidence supporting virucidal hand treatments for HRV prevention in the experimental setting, those authors provided several potential explanations for the discrepancy in the results: a lack of control in the natural setting for variables such as compliance and modes of transmission, potential protective effects of nasal secretions, and the potential for routes of virus transmission other than direct-contact self-inoculation.

Nonetheless, a systematic review of physical interventions to reduce the transmission of respiratory viruses found that hand washing with or without antiseptic was effective The results were most robust for children, who are least capable of performing hygienic behaviors by themselves. However, local adverse reactions, including nasal irritation, mucosal friability, and bleeding, have limited its use , Several double-blinded, placebo-controlled studies have found that different preparations of Echinacea are ineffective for the prevention of HRV infection or the development of HRV colds , , A Cochrane review of Echinacea for prophylaxis and treatment including three prevention trials in the natural setting confirmed these negative findings Vitamin C has been studied for the prevention and treatment of the common cold since and has been marketed as such since the s.

As an antioxidant, vitamin C may protect against the generation of oxidative stress during infections; in animal studies, vitamin C reduces the incidence and severity of bacterial and viral infections.

The belief that these benefits extend to human subjects has existed for many years. In , the Cochrane Library conducted a systematic review and meta-analysis of vitamin C for the prevention and treatment of the common cold Only placebo-controlled trials using doses of 0. Twenty-nine trials including more than 11, subjects found no difference in the incidences of colds between subjects treated with vitamin C and those given placebo; however, the duration and severity of colds were reduced albeit modestly.

Of note, the benefit was most pronounced in subjects undergoing brief periods of high physical stress, e. To date, there have been no HRV vaccines evaluated in clinical trials. Challenges to vaccine development include the presence of more than different HRV serotypes, the lack of epidemiological data to identify the most commonly circulating HRV strains, the incomplete understanding of antigenic differences between the recently discovered HRV-C species and known serotypes, and limited animal models of HRV infection to understand viral pathogenesis Effective vaccine development calls for the elucidation of antigenic epitopes common to most known HRV serotypes to induce the production of cross-reactive antibodies Recent work has focused on deriving antigenic peptides from one of the viral capsid proteins, VP1, which plays a central role in receptor binding and subsequent epithelial cell infection and is recognized by HRV-neutralizing antibodies However, no studies have moved beyond the in vitro phase; due to the challenges noted above, we are still far from clinical vaccine development.

Substantial advances in the field of HRV research have occurred in the last decade, due primarily to improvements in molecular diagnostics. HRV is not just a cause of benign upper respiratory illness; rather, it is a significant lower respiratory tract pathogen in patients with chronic pulmonary disease, children, and immunocompromised hosts.

Our understanding of HRV pathogenesis, drawn largely from in vitro data and in vivo studies of experimental infection of healthy adults, implicates both direct viral effects and tissue damage due to the host immune response.

The recently published full-length genomic sequences of all known HRV serotypes, including the group C viruses, will facilitate characterizations of HRV strains detected in the future. Additionally, whole-genome sequencing may provide insight into the observed differences in clinical symptoms and outcomes according to the HRV strain.

There is also a need to identify other modifiable risk factors for the acquisition and severity of HRV infection. A better understanding of the mechanisms leading to manifestations of HRV infection and the role of the host immune response is needed to guide future efforts at HRV prevention and treatment. Daryl M. Samantha E. Jacobs received a B.

During fellowship, she conducted studies on the clinical and molecular epidemiology of human rhinovirus infections in patients with hematologic malignancy and hematopoietic stem cell transplant recipients. In the fall of , Dr. Jacobs' current research interests include respiratory viral infections in immunocompromised hosts and infectious disease screening of solid-organ transplantation donors and recipients. He participates in viral outbreak investigations and is a major contributor to projects that introduce new molecular technologies and automation into the clinical laboratory.

His main research interest over the last 10 years has been molecular strain analysis of a wide variety of viral pathogens obtained from clinical specimens. Kirsten St. She is a virologist with interests in applied research, infectious disease surveillance, and laboratory regulatory issues.

Respiratory viral infections are a major focus for her laboratory, with projects on the investigation of mixed-virus infections, the evolution of antiviral resistance in influenza virus, and the development and validation of new diagnostic assays, including microarrays. Her laboratory is also the New York State reference laboratory for virology.

Before moving to Albany in , where Dr. Thomas J. Walsh completed 10 postdoctoral years of laboratory investigation, clinical research, and patient care with laboratory expertise in pharmacology, innate host defenses, molecular diagnostics, and medical mycology. Following a distinguished translational research career in the National Cancer Institute's Pediatric Oncology Branch, where he built an internationally recognized program leading to major advances in the diagnosis, treatment, and prevention of invasive fungal infections in children and adults with cancer, Dr.

Walsh was recruited to his current position at Weill Cornell Medical Center. The core mission of the Transplantation-Oncology Infectious Diseases Program is to conduct leading translational research, training, and patient care in the diagnosis, treatment, and prevention of life-threatening fungal, bacterial, and viral infections in immunocompromised patients.

National Center for Biotechnology Information , U. Journal List Clin Microbiol Rev v. Clin Microbiol Rev. Author information Copyright and License information Disclaimer.

Corresponding author. Address correspondence to Samantha E. Jacobs, ude. All Rights Reserved. This article has been cited by other articles in PMC. Abstract Human rhinoviruses HRVs , first discovered in the s, are responsible for more than one-half of cold-like illnesses and cost billions of dollars annually in medical visits and missed days of work.

Open in a separate window. Fig 1. Viral Replication Depending on the receptor type, virus uptake occurs via clathrin-dependent or -independent endocytosis or via macropinocytosis Fig. Fig 2. Transmission HRVs are transmitted from person to person via contact either direct or through a fomite or aerosol small or large particle 13 , Infection of Lower Airway Epithelium There is mounting evidence from experimental and observational studies to support the role of HRV as a lower respiratory tract pathogen.

Innate and Adaptive Host Response In addition to a direct effect on respiratory epithelial cells, the innate and adaptive host responses also have a role in the pathogenesis of HRV infection Fig. Fig 3. Animal Models The development of small-animal models is useful to understand further the pathogenesis of HRV infection in both the upper and lower airways; however, there are no known murine rhinoviruses. Mechanisms in Chronic Pulmonary Disease Asthma.

Chronic obstructive pulmonary disease. Cystic fibrosis. Clinical Syndromes Asymptomatic infections. Upper respiratory infections. Lower respiratory infections. Infections in Immunocompromised Hosts With the increasing use of newer molecular platforms for respiratory virus detection, including multiplex real-time PCR assays, HRV is increasingly being recognized as a significant cause of acute respiratory illness in immunocompromised hosts , Lung transplant recipients.

Patients with hematologic malignancy and hematopoietic stem cell transplant recipients. Exacerbations of Chronic Pulmonary Diseases Asthma. Health Care-Associated Infections Data are limited on the frequency and risk factors for the health care-associated transmission of HRV infection, including health care worker HCW -to-patient and patient-to-patient transmission, perhaps due to limited methods for HRV detection at facilities that do not use molecular detection methods.

HRV viral load. Coinfection with Other Respiratory Pathogens Bacterial pathogens. Fig 4. Viral pathogens. Fungal pathogens. Antigen Detection and Serology There is no common antigen among HRVs, and an increasingly large number of serotypes have been described; therefore, antigen detection assays are not used for routine detection. Virus Culture Conventional virus culture. Rapid culture methods. Organ culture. Additional amplification techniques. Respiratory virus detection panels. Whole-genome sequencing.

Fig 5. Capsid-Binding Agents The viral capsid was one of the first viral proteins targeted for the development of inhibitors of viral replication. Proteolytic Enzyme Inhibitors Rupintrivir. Alpha-2 Interferon Interferons have antiviral, antiproliferative, and immunological effects that impact host cell susceptibility to infection.

Echinacea Echinacea preparations are among the most widely used herbal medicines. Zinc Zinc has activity against HRVs, although its exact mechanism of action is unknown. Antihistamines First-generation i. Other Agents Tremacamra, targeting recombinant soluble ICAM-1, and enviroxime, with an unknown mechanism, are two compounds evaluated for HRV prevention and treatment that failed to show a benefit in clinical trials. Social Distancing and Respiratory Masks Behavioral strategies such as social distancing and respiratory mask application have been evaluated primarily in the context of pandemic influenza A virus and influenza-like illness prevention.

Hand Hygiene Hand-to-hand HRV transmission appears to be highly efficient, and individuals may also self-inoculate if a contaminated hand contacts nasal secretions.

Echinacea Several double-blinded, placebo-controlled studies have found that different preparations of Echinacea are ineffective for the prevention of HRV infection or the development of HRV colds , , Vitamin C Vitamin C has been studied for the prevention and treatment of the common cold since and has been marketed as such since the s.

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Rhinovirus-associated hospitalizations in young children. Interferon treatment holds promise but it could be tricky, she said, because it would be mostly effective in the days immediately after infection, when many people exhibit no symptoms. In theory, interferon treatment could be used prophylactically in people at high risk who have been in close contact with others diagnosed with COVID Trials of interferon in COVID are underway, and so far show a possible benefit early in infection, but not when given later.

These findings may help explain why at times of year when colds are common, rates of infections with other viruses such as influenza tend to be lower, Foxman said. There are concerns that as social distancing measures ease, common cold and flu viruses — which have been dormant over the past year — will come back in greater force. Nagarjuna R.



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