WHAT'S KNOWN ON THIS SUBJECT: Human rhinovirus has been known as the common cold agent. Recently, studies have reported that this virus is responsible for severe infections of the lower respiratory tract in children. Reports of factors that increase disease severity have been contradictory. WHAT THIS STUDY ADDS:This study identifies some of the factors involved in disease severity in HRV infections in children. We expect that children at risk for developing severe disease could be identified sooner and appropriate measures could be taken. abstract OBJECTIVE: To evaluate retrospectively human rhinovirus (HRV) infections in children up to 5 years old and factors involved in disease severity.METHODS: Nasopharyngeal aspirates from 434 children presenting a broad range of respiratory infection symptoms and severity degrees were tested for presence of HRV and 8 other respiratory viruses. Presence of host risk factors was also assessed.RESULTS: HRV was detected in 181 (41.7%) samples, in 107 of them as the only agent and in 74 as coinfections, mostly with respiratory syncytial virus (RSV; 43.2%). Moderate to severe symptoms were observed in 28.9% (31/107) single infections and in 51.3% (38/74) coinfections (P = .004). Multivariate analyses showed association of coinfections with lower respiratory tract symptoms and some parameters of disease severity, such as hospitalization. In coinfections, RSV was the most important virus associated with severe disease. Prematurity, cardiomyopathies, and noninfectious respiratory diseases were comorbidities that also were associated with disease severity (P = .007).CONCLUSIONS: Our study showed that HRV was a common pathogen of respiratory disease in children and was also involved in severe cases, causing symptoms of the lower respiratory tract. Severe disease in HRV infections were caused mainly by presence of RSV in coinfections, prematurity, congenital heart disease, and noninfectious respiratory disease. Pediatrics 2014;133:e312-e321 AUTHORS:

Respiratory syncytial virus (RSV) is well recognized as the most important pathogen causing acute respiratory disease in infants and

The main viruses involved in acute respiratory diseases among children are: respiratory syncytial virus (RSV), influenzavirus (FLU), parainfluenzavirus (PIV), adenovirus (AdV), human rhinovirus (HRV), and the human metapneumovirus (hMPV). The purpose of the present study was to identify respiratory viruses that affected children younger than five years old in Uberlândia, Midwestern Brazil. Nasopharyngeal aspirates from 379 children attended at Hospital de Clínicas (HC/UFU), from 2001 to 2004, with acute respiratory disease, were collected and tested by immunofluorescence assay (IFA) to detect RSV, FLU A and B, PIV 1, 2, and 3 and AdV, FLU A and B in 9.5% (36/379), PIV 1, 2 and 3 in 6.3% (24/ 379) and AdV in 3.7% (14/379). HRV were detected in 29. 6% (112/379) Viruses are the most frequent agents that cause acute respiratory infections (ARIs) and are responsible for a considerable percentage of childhood mortality (Williams et al. 2002). In Brazil, some reports from different geographical areas has revealed the viruses as the main cause of respiratory infections, as related in the cities of Fortaleza (Arruda et al. 1991), Rio de Janeiro (Nascimento et al. 1991), São Paulo (Miyao et al. 1999, Vieira et al. 2001), and Curitiba (Tsuchiya et al. 2005.The most important viruses involved in ARI are: respiratory syncytial virus (RSV), influenzaviruses types A and B (FLU A/B), parainfluenzavirus (PIV), adenovirus (AdV), human rhinovirus (HRV), and the human metapneumovirus (hMPV) (Miyao et al. 1999, Kuiken et al. 2003, Tsuchiya et al. 2005). The last one was recently identified by Hoogen et al. (2001).RSV is the main cause of viral lower respiratory tract illness in children (Miyao et al. 1999), particularly in those younger than six months old (mo.) (Queiróz et al. 2002. In addition, RSV infections are responsible for most cases of severe symptoms such as bronchiolitis with recurrent wheezing and pneumonia (Calegari et FLU is a serious public health problem worldwide, were children constitute the age group most affected (Neuzil et al. 2002). Although many infections caused by FLU could be prevented by effective vaccination program, it has been predicted that a pandemic is likely to emerge in a near future (Cox et al. 2003), caused by a virus variant not covered by the current vaccine, requiring, thus, a constant epidemiological surveillance.PIV seems to have pattern of seasonal occurrence and is considered an important cause of respiratory illnesses, particularly among young children (Monto 2002).AdV infections are common in all age groups, causing both hospital-and community-acquired epidemics. Moreover, AdV has been associated with hospitalizations of near-fatal asthma patients (Tan et al. 2003) and with cases of acute otitis media in children younger than two years old (Monobe et al. 2003).HRV is responsible for the majority of common colds during winter, causing upper respiratory infections (Arruda et al. 1991, Savolainen et al. 2003 and is considered a risk factor for acute otitis media (Monobe at al. 2003). ...

RSV is an important agent that causes ARIs; the clinical manifestations varied from mild to severe and patients frequently required hospitalization; RSV mostly affected children less than one year old.

The human metapneumovirus (hMPV) is a pathogen of the respiratory tract identified first in the Netherlands in 2001 and since then it has been detected worldwide. The purpose of this study was to identify and characterize hMPV in samples collected from children <5 years presenting with acute respiratory disease (ARD) seen at a public hospital in Uberlândia, in Southeastern Brazil. One hundred fourteen nasopharyngeal aspirates (NPAs) samples that were negative for the presence of nine other respiratory viruses were tested by reverse transcription polymerase chain reaction (RT-PCR) for the presence of hMPV RNA. Fourteen out of 114 (12.3%) samples were positive for presence of hMPV RNA. PCR products, obtained by the amplification of partial nucleotide sequence of gene N, were sequenced and compared with sequences deposited in GenBank. Sequences from eight samples were obtained and all four subtypes were identified. Also, the recently proposed sublineages "a" and "b" of subtype A2 were found; mean age was 21 months old; upper respiratory tract infection (URTI) was the most common clinical symptom; the virus was detected in samples collected from March to November, a period that corresponds to late summer to mid-spring in Brazil. This is the first study to describe the circulation of all hMPV subtypes in Minas Gerais state.