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. 2009 Aug 20;81(10):1831–1838. doi: 10.1002/jmv.21590

Rhinovirus infections in children: A retrospective and prospective hospital‐based study

Ville Peltola 1,✉, Tuomas Jartti 1, Anne Putto‐Laurila 1, Jussi Mertsola 1, Raija Vainionpää 2, Matti Waris 2, Timo Hyypiä 2, Olli Ruuskanen 1
PMCID: PMC7166645  PMID: 19697407

Abstract

To analyze clinical characteristics and prevalence of rhinovirus infections in children in the hospital, we reviewed a retrospective dataset from a 20‐year period, and conducted a short‐term prospective study. Records of children and adolescents treated at our hospital during 1987–2006 with a documented rhinovirus infection were reviewed and compared with patients with other respiratory virus infections. Prospective study included all children ≥1 month of age admitted to pediatric infectious disease ward during an autumn period. Rhinoviruses were detected by reverse transcription‐PCR and/or culture, and sequence analysis was used for virus typing. In the retrospective study, the median age of 580 children with rhinovirus infection was 1.9 years (interquartile range, 1.0–4.3 years), and 27% had an underlying medical condition. Eighty‐four children (16% of in‐patients) were treated at pediatric intensive care unit. Twenty‐one children (4%) had a hospital‐acquired rhinovirus infection. In the prospective study, rhinoviruses were detected in 28% of 163 hospital episodes. Acute wheezing illness was diagnosed in 61% of children with rhinovirus and in 31% of children with respiratory syncytial virus, enterovirus, or no study virus (P < 0.001). One‐half of sequence‐analyzed rhinovirus strains belonged to the newly identified C group. In conclusion, rhinovirus infections are a frequent cause of pediatric hospitalizations, and they are common also at the intensive care unit. Acute wheezing is the most frequent manifestation in hospital setting, but the range of clinical presentations is wide. Group C rhinoviruses may account for a large part of rhinovirus hospitalizations. J. Med. Virol. 81:1831–1838, 2009. © 2009 Wiley‐Liss, Inc.

Keywords: rhinovirus, respiratory virus, respiratory tract infection, wheezing illness, pneumonia

REFERENCES

  1. Arden KE, McErlean P, Nissen MD, Sloots TP, Mackay IM. 2006. Frequent detection of human rhinoviruses, paramyxoviruses, coronaviruses, and bocavirus during acute respiratory tract infections. J Med Virol 78: 1232–1240. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Arstila PP, Halonen PE. 1988. Direct antigen detection In: Lennette EH, Halonen P, Murphy FA, editors. Laboratory diagnosis of infectious diseases: Principle and practice. New York: Springer‐Verlag; pp 60–75. [Google Scholar]
  3. Calvo C, Garcia‐Garcia ML, Blanco C, Pozo F, Flecha IC, Perez‐Brena P. 2007. Role of rhinovirus in hospitalized infants with respiratory tract infections in Spain. Pediatr Infect Dis J 26: 904–908. [DOI] [PubMed] [Google Scholar]
  4. Cheuk DK, Tang IW, Chan KH, Woo PC, Peiris MJ, Chiu SS. 2007. Rhinovirus infection in hospitalized children in Hong Kong: A prospective study. Pediatr Infect Dis J 26: 995–1000. [DOI] [PubMed] [Google Scholar]
  5. Daubin C, Parienti JJ, Vincent S, Vabret A, du Cheyron D, Ramakers M, Freymuth F, Charbonneau P. 2006. Epidemiology and clinical outcome of virus‐positive respiratory samples in ventilated patients: A prospective cohort study. Crit Care 10: R142. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Halonen P, Rocha E, Hierholzer J, Holloway B, Hyypiä T, Hurskainen P, Pallansch M. 1995. Detection of enteroviruses and rhinoviruses in clinical specimens by PCR and liquid‐phase hybridization. J Clin Microbiol 33: 648–653. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hierholzer JC, Johansson KH, Anderson LJ, Tsou CJ, Halonen PE. 1987. Comparison of monoclonal time‐resolved fluoroimmunoassay with monoclonal capture‐biotinylated detector enzyme immunoassay for adenovirus antigen detection. J Clin Microbiol 25: 1662–1667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hyypiä T, Puhakka T, Ruuskanen O, Mäkelä M, Arola A, Arstila P. 1998. Molecular diagnosis of human rhinovirus infections: Comparison with virus isolation. J Clin Microbiol 36: 2081–2083. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Jackson DJ, Gangnon RE, Evans MD, Roberg KA, Anderson EL, Pappas TE, Printz MC, Lee WM, Shult PA, Reisdorf E, Carlson‐Dakes KT, Salazar LP, DaSilva DF, Tisler CJ, Gern JE, Lemanske RF, Jr. 2008. Wheezing rhinovirus illnesses in early life predict asthma development in high‐risk children. Am J Respir Crit Care Med 178: 667–672. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Jacques J, Bouscambert‐Duchamp M, Moret H, Carquin J, Brodard V, Lina B, Motte J, Andréoletti L. 2006. Association of respiratory picornaviruses with acute bronchiolitis in French infants. J Clin Virol 35: 463–466. [DOI] [PubMed] [Google Scholar]
  11. Jartti T, Lehtinen P, Vuorinen T, Österback R, van den Hoogen B, Osterhaus AD, Ruuskanen O. 2004. Respiratory picornaviruses and respiratory syncytial virus as causative agents of acute expiratory wheezing in children. Emerg Infect Dis 10: 1095–1101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Jartti T, Jartti L, Peltola V, Waris M, Ruuskanen O. 2008a. Respiratory viruses in asymptomatic subjects. Pediatr Infect Dis J 27: 1103–1107. [DOI] [PubMed] [Google Scholar]
  13. Jartti T, Lee WM, Pappas T, Evans M, Lemanske RF, Gern JE. 2008b. Serial viral infections in infants with recurrent respiratory illnesses. Eur Respir J 32: 314–320. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Juvén T, Mertsola J, Waris M, Leinonen M, Meurman O, Roivainen M, Eskola J, Saikku P, Ruuskanen O. 2000. Etiology of community‐acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J 19: 293–298. [DOI] [PubMed] [Google Scholar]
  15. Koskenvuo M, Möttönen M, Rahiala J, Saarinen‐Pihkala UM, Riikonen P, Waris M, Ziegler T, Uhari M, Ruuskanen O, Salmi TT. 2007. Mixed bacterial‐viral infections in septic children with leukemia. Pediatr Infect Dis J 26: 1133–1136. [DOI] [PubMed] [Google Scholar]
  16. Koskenvuo M, Möttönen M, Rahiala J, Saarinen‐Pihkala UM, Riikonen P, Waris M, Ziegler T, Uhari M, Salmi TT, Ruuskanen O. 2008. Respiratory viral infections in children with leukemia. Pediatr Infect Dis J 27: 974–980. [DOI] [PubMed] [Google Scholar]
  17. Kotaniemi‐Syrjänen A, Vainionpää R, Reijonen TM, Waris M, Korhonen K, Korppi M. 2003. Rhinovirus‐induced wheezing in infancy—The first sign of childhood asthma? J Allergy Clin Immunol 111: 66–71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kusel MM, de Klerk NH, Holt PG, Kebadze T, Johnston SL, Sly PD. 2006. Role of respiratory viruses in acute upper and lower respiratory tract illness in the first year of life: A birth cohort study. Pediatr Infect Dis J 25: 680–686. [DOI] [PubMed] [Google Scholar]
  19. Lahti E, Peltola V, Virkki R, Rantakokko‐Jalava K, Waris M, Jalava J, Eerola E, Mertsola J, Ruuskanen O. 2009. Induced sputum in diagnostics of childhood community‐acquired pneumonia. Thorax 64: 252–257. [DOI] [PubMed] [Google Scholar]
  20. Lamson D, Renwick N, Kapoor V, Liu Z, Palacios G, Ju J, Dean A, St George K, Briese T, Lipkin WI. 2006. MassTag polymerase‐chain‐reaction detection of respiratory pathogens, including a new rhinovirus genotype, that caused influenza‐like illness in New York State during 2004–2005. J Infect Dis 194: 1398–1402. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Lee WM, Kiesner C, Pappas T, Lee I, Grindle K, Jartti T, Jakiela B, Lemanske RF, Shult PA, Gern JE. 2007. A diverse group of previously unrecognized human rhinoviruses are common causes of respiratory illnesses in infants. PLoS ONE 2: e966. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Lehtinen P, Ruohola A, Vanto T, Vuorinen T, Ruuskanen O, Jartti T. 2007. Prednisolone reduces recurrent wheezing after a first wheezing episode associated with rhinovirus infection or eczema. J Allergy Clin Immunol 119: 570–575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Lemanske RF, Jr. , Jackson DJ, Gangnon RE, Evans MD, Li Z, Shult PA, Kirk CJ, Reisdorf E, Roberg KA, Anderson EL, Carlson‐Dakes KT, Adler KJ, Gilbertson‐White S, Pappas TE, Dasilva DF, Tisler CJ, Gern JE. 2005. Rhinovirus illnesses during infancy predict subsequent childhood wheezing. J Allergy Clin Immunol 116: 571–577. [DOI] [PubMed] [Google Scholar]
  24. Lönnrot M, Sjöroos M, Salminen K, Maaronen M, Hyypiä T, Hyöty H. 1999. Diagnosis of enterovirus and rhinovirus infections by RT‐PCR and time‐resolved fluorometry with lanthanide chelate labeled probes. J Med Virol 59: 378–384. [PubMed] [Google Scholar]
  25. Miller EK, Lu X, Erdman DD, Poehling KA, Zhu Y, Griffin MR, Hartert TV, Anderson LJ, Weinberg GA, Hall CB, Iwane MK, Edwards KM, New Vaccine Surveillance Network . 2007. Rhinovirus‐associated hospitalizations in young children. J Infect Dis 195: 773–781. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Monto AS, Bryan ER, Ohmit S. 1987. Rhinovirus infections in Tecumseh, Michigan: Frequency of illness and number of serotypes. J Infect Dis 156: 43–49. [DOI] [PubMed] [Google Scholar]
  27. Myatt TA, Johnston SL, Zuo Z, Wand M, Kebadze T, Rudnick S, Milton DK. 2004. Detection of airborne rhinovirus and its relation to outdoor air supply in office environments. Am J Respir Crit Care Med 169: 1187–1190. [DOI] [PubMed] [Google Scholar]
  28. Nikkari S, Halonen P, Kharitonenkov I, Kivivirta M, Khristova M, Waris M, Kendal A. 1989. One‐incubation time‐resolved fluoroimmunoassay based on monoclonal antibodies in detection of influenza A and B viruses directly in clinical specimens. J Virol Methods 23: 29–40. [DOI] [PubMed] [Google Scholar]
  29. Peltola V, Ziegler T, Ruuskanen O. 2003. Influenza A and B virus infections in children. Clin Infect Dis 36: 299–305. [DOI] [PubMed] [Google Scholar]
  30. Peltola V, Mertsola J, Ruuskanen O. 2006a. Comparison of total white blood cell count and serum C‐reactive protein levels in confirmed bacterial and viral infections. J Pediatr 149: 721–724. [DOI] [PubMed] [Google Scholar]
  31. Peltola V, Waris M, Hyypiä T, Ruuskanen O. 2006b. Respiratory viruses in children with invasive pneumococcal disease. Clin Infect Dis 43: 266–268. [DOI] [PubMed] [Google Scholar]
  32. Peltola V, Waris M, Österback R, Susi P, Ruuskanen O, Hyypiä T. 2008. Rhinovirus transmission within families with children: Incidence of symptomatic and asymptomatic infections. J Infect Dis 197: 382–389. [DOI] [PubMed] [Google Scholar]
  33. Rawlinson WD, Waliuzzaman Z, Carter IW, Belessis YC, Gilbert KM, Morton JR. 2003. Asthma exacerbations in children associated with rhinovirus but not human metapneumovirus infection. J Infect Dis 187: 1314–1318. [DOI] [PubMed] [Google Scholar]
  34. Renwick N, Schweiger B, Kapoor V, Liu Z, Villari J, Bullmann R, Miething R, Briese T, Lipkin WI. 2007. A recently identified rhinovirus genotype is associated with severe respiratory‐tract infection in children in Germany. J Infect Dis 196: 1754–1760. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Richard N, Komurian‐Pradel F, Javouhey E, Perret M, Rajoharison A, Bagnaud A, Billaud G, Vernet G, Lina B, Floret D, Paranhos‐Baccala G. 2008. The impact of dual viral infection in infants admitted to a pediatric intensive care unit associated with severe bronchiolitis. Pediatr Infect Dis J 27: 213–217. [DOI] [PubMed] [Google Scholar]
  36. Tsolia MN, Psarras S, Bossios A, Audi H, Paldanius M, Gourgiotis D, Kallergi K, Kafetzis DA, Constantopoulos A, Papadopoulos NG. 2004. Etiology of community‐acquired pneumonia in hospitalized school‐age children: Evidence for high prevalence of viral infections. Clin Infect Dis 39: 681–686. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Valenti WM, Clarke TA, Hall CB, Menegus MA, Shapiro DL. 1982. Concurrent outbreaks of rhinovirus and respiratory syncytial virus in an intensive care nursery: Epidemiology and associated risk factors. J Pediatr 100: 722–726. [DOI] [PubMed] [Google Scholar]
  38. Verboon‐Maciolek MA, Krediet TG, Gerards LJ, Fleer A, van Loon TM. 2005. Clinical and epidemiologic characteristics of viral infections in a neonatal intensive care unit during a 12‐year period. Pediatr Infect Dis J 24: 901–904. [DOI] [PubMed] [Google Scholar]
  39. Vesa S, Kleemola M, Blomqvist S, Takala A, Kilpi T, Hovi T. 2001. Epidemiology of documented viral respiratory infections and acute otitis media in a cohort of children followed from two to twenty‐four months of age. Pediatr Infect Dis J 20: 574–581. [DOI] [PubMed] [Google Scholar]
  40. Waris M, Halonen P, Ziegler T, Nikkari S, Obert G. 1988. Time‐resolved fluoroimmunoassay compared with virus isolation for rapid detection of respiratory syncytial virus in nasopharyngeal aspirates. J Clin Microbiol 26: 2581–2585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Wenzel RP, Deal EC, Hendley JO. 1977. Hospital‐acquired viral respiratory illness on a pediatric ward. Pediatrics 60: 367–371. [PubMed] [Google Scholar]

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