Human Rhinovirus Species Vary By Season And Diagnosis In 21-year Prospective Pediatric Cohort

Abstract

Human rhinoviruses (HRV) are common triggers of asthma exacerbation. The role of the newly described HRVC in upper (URI) and lower respiratory illness (LRI) in children over time is poorly understood. Here we examine HRVC in relationship to other HRV species and disease severity over a 21-year period. Using Real Time RT-PCR, we tested nasal-wash specimens for HRV, obtained from children enrolled from 1982-2003, presenting with acute respiratory tract illness or otitis media (OM). We sequenced the VP4/VP2 gene from HRV-positive specimens to determine species. Of 527 samples tested, 190 (36.1%) were positive for HRV: 48% of these were HRVA, 3% HRVB, 36% HRVC, and 13% untypable. Of 407 children with URI, 75% had HRV: 54% were HRVA and 32% HRVC (p=0.0002). Of 120 children with LRI, 40% had HRV: 31% HRVA and 50% HRVC (P = 0.06). Of HRV-positive patients with coryza, 2% had HRVA and 42% HRVC (p=0.018). Of HRV-positive patients with acute OM, 57% had HRVA and 27% HRVC (p=0.0001). Of HRV-positive patients with wheezing (bronchiolitis or asthma), 29% had HRVA and 48% HRVC (p=0.12). HRVA and HRVC often peaked during alternate months; overall HRVA was more likely than HRVC to be present in July and October, and in 1988, 2001, and 2002. Our data support that HRVC is not a “new” virus and that HRV species vary over season and time. Because different species are associated with distinct diagnoses, tracking HRV species through time may help us understand patterns in severity of disease and diagnoses.