Rhinovirus species B commonly found in well children

VANCOUVER, Canada — Children aged 4 to 7 years typically have approximately two upper respiratory infections each year, which is less than in previous studies, according to data presented here during the 2014 Pediatric Academic Societies Annual Meeting.

Gregory P. DeMuri, MD, and colleagues, including Infectious Disease in Children Editorial Board member Ellen R. Wald, MD, presented results of a prospective study describing the clinical and virological features of upper respiratory infection (URI) in 157 children aged 4 to 6 years.

Gregory P. DeMuri

More specifically, children were enrolled between Feb. 1, 2012, and Feb. 28, 2014, as part of a study to determine the relationship between acute viral URI and sinusitis; 64 patients were followed for 1 year and completed at least three surveillance visits. Parents were instructed to call the study nurse at the first sign of a URI and were seen on day 2 to 3 of illness.

During the study period, 220 URIs were reported, and the mean number of URIs per year was 2.2 (range 0-9, standard deviation, 2.0); 33% of patients had three or more URIs per year. Mean symptom scores on days 3, 7, 10 and 15 were 8.0, 3.4, 3.1 and 1.1, respectively. Fever was present in 5.1% of URIs on day 3 and resolved by day 7.

DeMuri said that URI symptoms resolved in most children before day 10, and sinusitis complicated URIs in 9% of cases, which was slightly higher than anticipated.

He also said URI complications were reported in 214 URIs, including symptoms consistent with sinusitis in 9% of URIs. Sinusitis was defined as persistent symptoms of nasal discharge or cough or both that lasted 10 days or longer; severe symptoms of purulent nasal discharge plus temperature of 39°C or higher for 72 hours; and worsening of respiratory symptoms or fever after apparent improvement.

A total of 14% of URIs resulted in an otitis media diagnosis, and 10.3% of URIs resulted in a clinic visit.

Viral PCR was performed in 109 URIs, which revealed one or more viruses in 86% of samples. Rhinovirus was detected in 43%; coronavirus in 17%; bocavirus in 3%; influenza in 7%; adenovirus in 3%; enterovirus in 3%; parainfluenza in 7%; metapneumovirus in 2%; and respiratory syncytial virus (RSV) in 1%. Multiple viruses were detected in 12% of URI episodes. Compared with rhinovirus, mean symptom scores on day 10 were higher for adenovirus, enterovirus, influenza and RSV (P<.01).

DeMuri told Infectious Diseases in Children that they also surveyed children for respiratory viruses when they were well and when they were ill.

“We found the typical variety of respiratory viruses when they were sick, but when they were well, we also found quite a few viruses, including rhinovirus. This has been found before but I think that it’s really important when you ascribe rhinovirus to a clinical illness, you have to consider that there is a lot of background rhinovirus,” he said.

Additional significant findings of the study included that rhinovirus was the most frequent virus detected in patients with URI symptoms, and URIs associated with adenovirus, enterovirus, influenza and RSV were more severe than those found with rhinovirus. — by Cassandra A. Richards

For more information:

De Muri GP. Abstract#1522.318. Presented at PAS 2014; May 2-6, 2014; Vancouver, Canada.

Disclosure: DeMuri reports no relevant financial disclosures.