Human rhinovirus C associated with wheezing in hospitalised children in the Middle East

Miller, E. Kathryn; Khuri‐Bulos, Najwa; Williams, John V.; Shehabi, Asem A.; Faouri, Samir; Jundi, Ihsan Al; Chen, Qingxia; Heil, Luke; Mohamed, Yassir A.; Morin, Laura-Lee; Ali, Asad; Halasa, Natasha

doi:10.1016/j.jcv.2009.06.007

Cited by 119 publications

(170 citation statements)

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“…Previously, we have shown that HRV-C is the most common virus detected in children with acute asthma exacerbations and is associated with more severe episodes compared with other viruses (23). Yet, other studies have found variable results on HRV in young children with ARIs (21,(26)(27)(28)(29)(30). This could be due to the inclusion of milder cases, as HRV-C appears to be most common in children with more severe wheezing exacerbations.…”

Section: Discussionmentioning

confidence: 90%

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Human Rhinovirus Species C Infection in Young Children with Acute Wheeze Is Associated with Increased Acute Respiratory Hospital Admissions

Cox

Bizzintino

Ferrari³

et al. 2013

Am J Respir Crit Care Med

156

124

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Rationale: Human rhinovirus species C (HRV-C) is the most common cause of acute wheezing exacerbations in young children presenting to hospital, but its impact on subsequent respiratory illnesses has not been defined. Objectives: To determine whether acute wheezing exacerbations due to HRV-C are associated with increased hospital attendances due to acute respiratory illnesses (ARIs). Methods: Clinical information and nasal samples were collected prospectively from 197 children less than 5 years of age, presenting to hospital with an acute wheezing episode. Information on hospital attendances with an ARI before and after recruitment was subsequently obtained. Measurements and Main Results: HRV was the most common virus identified at recruitment (n ¼ 135 [68.5%]). From the 120 (88.9%) samples that underwent typing, HRV-C was the most common HRV species identified, present in 81 (67.5%) samples. Children with an HRV-related wheezing illness had an increased risk of readmission with an ARI (relative risk, 3.44; 95% confidence interval, 1.17-10.17; P ¼ 0.03) compared with those infected with any other virus. HRV-C, compared with any other virus, was associated with an increased risk of a respiratory hospital admission before (49.4% vs. 27.3%, respectively; P ¼ 0.004) and within 12 months (34.6% vs. 17.0%; P ¼ 0.01) of recruitment. Risk for subsequent ARI admissions was further increased in atopic subjects (relative risk, 6.82; 95% confidence interval, 2.16-21.55; P ¼ 0.001). Admission risks were not increased for other HRV species. Conclusions: HRV-C-related wheezing illnesses were associated with an increased risk of prior and subsequent hospital respiratory admissions. These associations are consistent with HRV-C causing recurrent severe wheezing illnesses in children who are more susceptible to ARIs. Keywords: human rhinovirus; acute wheezing illnesses; hospital admissions; pediatricsNumerous studies have demonstrated that wheezing associated with certain viruses in early childhood is an independent risk factor for subsequent wheezing illnesses and the development of asthma (1-7). Most earlier reports focused on respiratory syncytial virus (RSV) bronchiolitis in infancy and recurrent wheezing (1-3, 8, 9), but more recent research has shown that wheezing episodes due to human rhinovirus (HRV) have a stronger association than RSV with further wheezing episodes and asthma in early childhood (4,5,7,9).Previously, HRV-A and -B (10-12) were the only known HRV species, but improved virological detection methods using polymerase chain reaction (PCR) and sequencing (13-15) have revealed another species of rhinovirus, C (16,17). A number of studies have shown that HRV-C is the most common HRV species associated with acute asthma attacks severe enough to result in children presenting to hospital (18-21), and further studies have shown that it also causes more severe asthma attacks than other rhinoviruses (22) and all other viruses (23).These studies raise the issue of whether HRV-C also influences subsequent acute wheezing e...

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Section: Discussionmentioning

confidence: 90%

“…A number of studies have shown that HRV-C is the most common HRV species associated with acute asthma attacks severe enough to result in children presenting to hospital (18)(19)(20)(21), and further studies have shown that it also causes more severe asthma attacks than other rhinoviruses (22) and all other viruses (23).…”

mentioning

confidence: 99%

Human Rhinovirus Species C Infection in Young Children with Acute Wheeze Is Associated with Increased Acute Respiratory Hospital Admissions

Cox

Bizzintino

Ferrari³

et al. 2013

Am J Respir Crit Care Med

156

124

View full text Add to dashboard Cite

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“…Since then, multiple studies have compared the virulence of HRV-C relative to the classical HRV-A and -B species (13,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36). In several of these studies, HRV-C viruses appear to be overrepresented compared with HRV-A and -B in infants and children with lower respiratory infections and in exacerbations of childhood asthma.…”

Section: Discussionmentioning

confidence: 99%

Human Rhinovirus Species and Season of Infection Determine Illness Severity

Lee¹,

Lemanske²,

Evans

et al. 2012

Am J Respir Crit Care Med

283

266

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Rationale: Human rhinoviruses (HRVs) consist of approximately 160 types that cause a wide range of clinical outcomes, including asymptomatic infections, common colds, and severe lower respiratory illnesses. Objectives: To identify factors that influence the severity of HRV illnesses. Methods: HRV species and types were determined in 1,445 nasal lavages that were prospectively collected from 209 infants participating in a birth cohort who had at least one HRV infection. Questionnaires were used during each illness to identify moderate to severe illnesses (MSI). Measurements and Main Results: Altogether, 670 HRV infections were identified, and 519 of them were solitary infections (only one HRV type). These 519 viruses belonged to 93 different types of three species: 49 A, 9 B, and 35 C types. HRV-A (odds ratio, 8.2) and HRV-C (odds ratio, 7.6) were more likely to cause MSI compared with HRV-B. In addition, HRV infections were 5-to 10-fold more likely to cause MSI in the winter months (P , 0.0001) compared with summer, in contrast to peak seasonal prevalence in spring and fall. When significant differences in host susceptibility to MSI (P ¼ 0.004) were considered, strain-specific rates of HRV MSI ranged from less than 1% to more than 20%. Conclusions: Factors related to HRV species and type, season, and host susceptibility determine the risk of more severe HRV illness in infancy. These findings suggest that anti-HRV strategies should focus on HRV-A and -C species and identify the need for additional studies to determine mechanisms for seasonal increases of HRV severity, independent of viral prevalence, in cold weather months.Keywords: rhinovirus; severe illness; species; type; seasonality Human rhinoviruses (HRVs) are the most prevalent human respiratory viruses. Annually, they infect billions of people and are responsible for at least one-half of all acute upper respiratory illnesses (common colds), the most common illness of humans (1-3). In addition to common colds, infections with HRV result in a wide range of other clinical outcomes ranging from asymptomatic infection to severe lower respiratory illnesses, such as bronchiolitis, pneumonia, and exacerbations of asthma (1, 4-7). It is likely that host, viral, and environmental factors contribute to the severity of illness caused by HRV infection. Indeed, more severe HRV infections are associated with phenotypic characteristics such as extremes in age; chronic respiratory diseases such as asthma; reduced interferon responses in the blood and airway; and, in early life, male sex and reduced lung function (4,8). Little is known about viral and environmental determinants of illness severity.HRVs are a large group of genetically diverse RNA viruses and are classified phylogenetically into three species (A, B, and C). The 100 classical serotypes are found within species A and B, and approximately 50 newly identified types are HRV-Cs (5, 9-15). This tremendous genetic diversity represents a major obstacle toward developing both antivirals and vaccines for HRV, and iden...

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“…13 Asimismo, se ha hallado la presencia de RVH en pacientes con bronquiolitis, 14 neumonía, 15 EPOC, 16 fibrosis quís-tica 17 y pacientes inmunocomprometidos, tanto en niños como en adultos. Miller y col., 18 demostraron que la historia familiar de atopía, especialmente en la madre, fue un factor de riesgo para presentar bronquiolitis grave en 630 niños pequeños hospitalizados y ambulatorios.…”

Section: Discussionunclassified

Infección respiratoria aguda viral en niños menores de 5 años. Estudio epidemiológico en dos centros de Buenos Aires, Argentina

Vidaurreta

Marcone

Ellis³

et al. 2011

Arch Argent Pediat

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Arch Argent Pediatr 2011;109(4):296-304 / 296 RESUMEN Introducción. Las infecciones respiratorias agudas (IRA) son la mayor causa de hospitalización en edades extremas de la vida. Objetivos. Identificar los agentes etiológicos de IRA viral en niños < 5 años hospitalizados y ambulatorios; describir estacionalidad y caracterís-ticas clínico-epidemiológicas de la enfermedad. Población y métodos. Estudio descriptivo, transversal y multicéntrico en dos centros privados de Buenos Aires, en niños con IRA alta y baja. Se registraron antecedentes, cuadros clínicos y estudios virológicos. Resultados. Se estudiaron 347 pacientes: 235 hospitalizados; 112 ambulatorios. Los hospitalizados fueron menores que los ambulatorios (8 vs. 19 meses, p <0,001), presentaron más frecuentemente bronquiolitis (74% hospitalizados vs. 24% ambulatorios) y neumonía (14% hospitalizados vs. 5% ambulatorios). Solo la edad se asoció significativamente a hospitalización (p= 0,01). Se identificó etiología viral en 81% de los hospitalizados y 57% de los ambulatorios. El virus más frecuente fue rinovirus seguido por virus respiratorio sincicial. Se observó circulación viral durante todo el año, especialmente en otoño e invierno. En pacientes hospitalizados, la mediana de hospitalización fue 3,5 días. Requirieron cuidados intensivos 25 (11%) pacientes, y 7 (3%) recibieron asistencia ventilatoria mecánica. No hubo letalidad. Conclusiones. Las técnicas de diagnóstico virológico permitieron identificar agentes etiológicos en la mayoría de los pacientes hospitalizados y en más de la mitad de los ambulatorios con IRA. La incorporación de RT-PCR para rinovirus, permitió la identificación de este agente etioló-gico. La circulación viral se observó a lo largo de todo el año. La bronquiolitis fue causa de internación en 174/201 (86,5%) niños con IRA y la neumonía en 33/39 (84,6%) niños. Palabras clave: virus respiratorios, infección respiratoria aguda, bronquiolitis, RT-PCR, rinovirus. SUMMARY Introduction. Acute respiratory infections (ARI)are a major cause of hospitalization particularly at the extreme ages of life. Objectives. To determine the viral diagnosis in children < 5 years old with ARI, seasonality, clinical and epidemiological characteristics. Population and methods. A cross-sectional, descriptive and multicenter study was performed. Respiratory samples from patients with ARI hospitalized or outpatients with < 5 days of respiratory symptoms from June 2008 to May 2009 were studied for respiratory viruses. Clinical and demographic data were recorded. Results. A total of 347 patients were enrolled: 234 hospitalized and 112 outpatients. Hospitalized patients were younger compared with outpatients (8 vs. 19 months, p <0.001) and presented more frequently bronchiolitis (74% hospitalized vs. 24% outpatients) and pneumonia (14% hospitalized vs. 5% outpatients). Age was statistically associated with hospitalization (p= 0.01). Viral diagnosis was achieved in 81% hospitalized and 57% of outpatients. Rhinovirus was the most frequent followed by respiratory sync...

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Human rhinovirus C associated with wheezing in hospitalised children in the Middle East

Abstract: Background-Few studies have investigated the disease burden and genetic diversity of human rhinoviruses (HRV) in developing countries.

Cited by 119 publications

References 40 publications

Human Rhinovirus Species C Infection in Young Children with Acute Wheeze Is Associated with Increased Acute Respiratory Hospital Admissions

Human Rhinovirus Species C Infection in Young Children with Acute Wheeze Is Associated with Increased Acute Respiratory Hospital Admissions

Human Rhinovirus Species and Season of Infection Determine Illness Severity

Infección respiratoria aguda viral en niños menores de 5 años. Estudio epidemiológico en dos centros de Buenos Aires, Argentina

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