Rhinovirus

an update
Dr.T.V.Rao MD

Dr.T.V.Rao MD

Viral Organisms in U.R.I.

Adults
Common cold Pharyng Tracheobronchitis Pneumonia

RHINOVIRUSES
INFLUENZA type A INFLUENZA type B CORONAVIRUSES ADENOVIRUSES (types 1-5,7) EPSTEIN-BARR VIRUS RSV PARAINFLUENZA (types 1-3) COXSACKIE (group A & B) ECHOVIRUS

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Dr.T.V.Rao MD

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Viral Organisms in U.R.I.

Children
Coryza RSV PARAINFLUENZA (type 3) PARAINFLUENZA (type 2) PARAINFLUENZA (type 1) RHINOVIRUSES INFLUENZA type A INFLUENZA type B ADENOVIRUSES (types 1-3,5) ++ ++ ++ ++ ++ + Pharyngitis + + + + + + + + Croup + + +++ + Tr.bronchitis ++ ++ + + + Pneumonia +++ ++ + + +

CORONAVIRUSES
EPSTEIN-BARR VIRUS COXSACKIE (group A & B) ECHOVIRUS

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+ +
Dr.T.V.Rao MD

Rhinoviruses
Rhinoviruses (from the Greek (gen.) "nose") are the most common viral infective agents in humans and are the predominant cause of the common cold. Rhinovirus infection proliferates in temperatures between 3335 C (9195 F), and this may be why it occurs primarily in the nose. Rhinovirus is a species in the genus Enterovirus of the Picornaviridae

family of viruses.
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Viral Rhinitis
sites infected
Rhinovirus nose > pharynx > saliva
90% 70% Coronavirus ?nose U & L.RT 50%

Parainfluenza, RSV, adenovirus

Influenza extensive destruction of U & L.RT (ciliated, intermediate and basal cells of epithelium)
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Ebisava et al, 1969) 5

 Rhinoviruses are the most commonly

isolated viruses from persons with mild upper respiratory illness.

Rhinoviruses are ..

Rhinoviruses are a genus of picornaviridae In contrast to enteroviruses they do not

replicate in the intestinal tract, they have an extreme species specificity and more fastidious growth requirements

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RHINOVIRUS GROUP
Produces Common Cold. Mild respiratory Illness. More than 100 serotypes Nasal secretions are infective. Mistaken with Infections with Corona viruses, Adenovirus. Para influenza viruses. Influenza viruses
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Properties of Rhinoviruses.
Gross appearance like Entero viruses, Acid Labile destroyed at 3.0 pH. Grown in Human Cell lines, WI 38 MRC -5 Cultivated at 330 c
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Rhinovirus
Picornoviridae family Size Single stranded Incubation period of 1 to 3 days Optimum growth occurs between 33 and 34 deg Celsius (93 deg F) Not stable below the pH of 5-6
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Rhino Virus

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Structure

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Entering a Cell

Rhinovirus bonded to a CAM Antibodies bonded to a 1 receptor Dr.T.V.Rao MD rhinovirus

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Understanding Common cold

leading cause of doctor visits and lost hours both at school and the workplace over >100 different viruses found to cause symptoms of the common cold responsible for about 70% of the cases where a virus has been found one of the most common illnesses to man 35 to 50% of the total number of common colds

Hand to hand contact

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Transmission of Rhinoviruses
There are two modes of transmission: via aerosols of respiratory droplets and from contaminated surfaces, including direct person-toperson contact.

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Pathogenesis - Rhinoviruses
Entry through Respiratory tract. Nasal Mucosa, can infect Lower Respiratory tract. Chilling, wearing wet cloths do not produce infection. But common cold starts with chills. Local inflammation and cytokines may be responsible for the symptoms of common cold.
Interferon production occurs early and specific Dr.T.V.Rao MD antibody appears in nasal secretions
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Pathogenesis
Epithelial destruction hypothesis:

intact nasal epithelium (Winther et al) rhinovirus replication in extremely

small number of cells (Arrunda et al)

viral quantity does not influence

duration nor severity of colds (Arrunda
et al)
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Pathogenesis
Inflammatory cascade hypothesis:
Common cold symptoms result from an inflammatory cascade triggered by a viral infection

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Cytokines initiate pathogenic process

Small number of virus infected cells elaborate a variety of cytokines initiating a host inflammatory response, which orchestrate chemotaxis and expression of endothelial adhesion receptor molecules resulting in the typical common cold symptoms.
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Interleukin-1
T-cell activation B-cell profileration, antibody synthesis up-regulation adhesion molecule expression mediator, cytokine, growth factor induction

increased vascular permeabilitiy

up-regulation kinin receptor expression

hematopoietic progenitor cell stimulation

neuro-endocrine interactions Dr.T.V.Rao MD
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Clinical Findings.
Incubation 2-4 days, Last for 7 days. Sneezing, Nasal Obstruction, Sore throat, May lead to secondary infection with Bacteria.
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The common cold, nasal congestion is

caused by a vasodilation of the subepithelial capillaries and of the cavernous sinuses, by edema in the lamina propria and by inflammatory processes in which neutrophils and kinins play an important role.

o Histamine plays only a minor role in the symptoms of common cold o Little is known about the role of prostaglandins and leukotrienes in the common cold.
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Clinical Findings.
Incubation 2-4 days, Last for 7 days. Sneezing, Nasal Obstruction, Sore throat, May lead to secondary infection with Bacteria.
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Laboratory Diagnosis
Isolation of virus may be obtained from nasal or throat swabs collected early in infection. Culturing on MRC5 or W 138 Appearing of CPE

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Immunity Rhinoviruses.
Antibodies in Nose Recurrent infections with antigenic variants, may be 2-3 attacks a year.
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Prevention and Control

No specific treatment. Vaccines are unsuccessful. Intranasal spray of Gamma Interferon for 5 Days

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Epidemiology - Rhinoviruses.
Prevalent all over the

world. Close Contact. Fingers and Hand - Hand washing. High rate of infection in Infants and Children.
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CDC Recommends
The CDC recommends that children with symptoms lasting more than 10 days who are unresponsive to overthe-counter medications or with fevers over 100.4 degrees Fahrenheit seek medical attention.
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Stop Spreading the Virus

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Use Tissue Paper

Use paper :Instead of shared cloth towels. Individuals with colds should always sneeze or cough into a facial tissue, and promptly throw it
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Hand washing
Hand washing is the simplest and most effective way to keep from getting rhinovirus colds. Children and adults should wash hands at key moments after nose-wiping, after diapering or toileting, before eating, and before preparing food.
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Treatments are Still Experimental

DRACO, a broad-spectrum antiretroviral therapy being developed at the Massachusetts Institute of Technology, has shown preliminary effectiveness in treating rhinovirus, as well as a number of other infectious viruses
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Preventing Common Cold

There is no vaccine to protect you against the common cold. However, you may be able to reduce your risk of getting a cold by taking these steps: wash your hands often with soap and water do not touch your eyes, nose, or mouth with unwashed hands stay away from people who are sick
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Prospects of Vaccine
There are no vaccines against these viruses as there is little-to-no cross-protection between serotypes. At least 99 serotypes of Human rhinoviruses affecting humans have been sequenced. However, recent study of the VP4 protein has shown it to be highly conserved amongst many serotypes of Human rhinovirus, opening up the potential for a future pan-serotype Human rhinovirus vaccine.
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 The Programme Created by Dr.T.V.Rao MD for Medical and Health care Workers in the Developing World
Email

doctortvrao@gmail.com
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