Table 2.
Common and uncommon community-acquired respiratory viruses that may cause severe respiratory viral infection
| Virus | Epidemiologic and clinical features | Additional infection control precautionsa |
|---|---|---|
| Common respiratory viruses | ||
| Influenza A and influenza B |
Only influenza type A viruses are known to have caused pandemics Currently circulating seasonal influenza A viruses in humans: subtype A(H1N1)pdm09 and A(H3N2) strains Currently circulating influenza B viruses: A/Victoria-like, A/Yamagata-like strains May be associated with acute myocardial infarction, myocarditis, rhabdomyolysis, acute renal failure, encephalopathy/encephalitis, and other non-pulmonary complications |
Droplet |
| Picornaviruses (rhinovirus, enterovirus) |
Frequently detected in critically ill patients with severe acute respiratory infection. May cause severe illness in the elderly, persons with co-morbidities including immunosuppression. |
Droplet |
| Human coronaviruses (229E, NL63, OC43, HKU1) | Contact | |
| Respiratory syncytial virus | Contact | |
| Human metapneumovirus | Contact | |
| Parainfluenza (1-4) | Contact | |
| Adenoviruses | Droplet + contact | |
| Uncommon and emerging viruses | ||
| Avian influenza A/H5N1, A/H5N6, A/H7N9 and other subtypes |
Residence in or travel to Southeast and East Asia Exposure to poultry or visit to poultry market |
Airborne + contact |
| MERS-CoV |
Residence in or travel to the Arabian Peninsula Exposure to dromedary camel (in endemic areas) Nosocomial transmission risk to other patients and to healthcare workers |
Airborne + contact |
| SARS-CoV |
No cases have been reported since 2004 Nosocomial transmission risk to other patients and to healthcare workers |
Airborne + contact |
| 2019 Novel coronavirus (2019 nCoV) | As of February 4, 2020, 20630 cases were reported from China and 23 other countries | Droplet + contact and wherever possible airborneb |
| Measlesc |
Incomplete vaccination Characteristic rash. Progressive giant cell pneumonia without rash may occur in immunocompromised (Hecht’s pneumonia) |
Airborne |
| Hantaviruses (e.g., Sin Nombre, Andes)c |
Residence in or travel to affected areas of North, Central, or South America Exposure to rodent excretions particularly when cleaning buildings |
Standard |
| Varicella-zoster virusc |
Incomplete vaccination, pregnancy Often with characteristic rash |
Airborne + contact |
Please refer to the online supplement for references
Infection control precautions are based on the Centers for Disease Control and Prevention at: https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/type-duration-precautions.html#M, https://www.cdc.gov/coronavirus/mers/infection-prevention-control.html, https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/standard-precautions.html, https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm (all accessed on Dec 10-2019)
aAll suspected or confirmed RVIs require minimum of standard precautions. Eye protection is a reasonable addition to droplet isolation as the ocular route of infection has been documented for several common respiratory viruses
bData on the novel coronavirus are based on the WHO interim report as of February 4, 2020
cOther viral pathogens with respiratory routes of acquisition