Rhinovirus

Rhinovirus is best known as the common cold. It is a
member of the picornaviridae family along with more
virulent viruses such as polio and hepatitis A. The
viruses of this family are characterized as small (20-
30nm genome) positive polarity RNA viruses consisting
of one genome segment and a nonenveloped capsid.
Unlike the its more lethal relatives, Rhinovirus is
designed to attack a host numerous times during their
lifetime. It is the perfect pathogen. It is estimated that
adults suffer from 2 to 4 infections with the virus each
year.

Rhinoviruses are..
 Rhinoviruses are the most commonly isolated viruses
from persons with mild upper respiratory illness.
 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

Epidemiology
 Common colds are most frequent from September to April in temperate
climates. RV infections, which are present throughout the year, account for
the initial increase in cold incidence during the fall (causing as many as 80%
of colds in this period) and for a second incidence peak at the end of spring.
Colds that occur from October through March are caused by the successive
appearance of numerous viruses (see the image below). Adenovirus infections
occur at a constant rate throughout the season.
 The incidence of the common cold is highest in preschool- and elementary
school–aged children. An average of 3-8 colds per year is observed in this age
group, and the incidence is even higher in children who attend daycare and
preschool. Because of the numerous viral agents involved and the multiple
serotypes that several of these agents (especially RV) have, it is not unusual
for younger children having new colds every month during the winter. Adults
and adolescents typically have 2-4 colds per year.

International Statistics
 Internationally, RV is a significant cause of respiratory tract
infection, as well as a minor cause of bronchiolitis. RVs have
been found in all countries, even in remote areas such as the
Kaluhi Islands and the Amazon. In Brazil, RVs reportedly cause
46% of ARTIs. A seasonal increase in incidence during the
winter months is observed worldwide.

Cont.
 Age-related demographics
Because antibodies to viral serotypes develop over time, the incidence of RV
infection is highest in infants and young children and falls as children
approach adulthood. Young children are more likely to have the frequent,
close, personal contact necessary to transmit RV; they commonly pass the
infection to family members after acquiring the virus in nurseries, daycare
facilities, and schools. Children may also be more contagious by virtue of
having higher virus concentrations in secretions and longer duration of viral
shedding.
 Sex-related demographics
Some reports indicate a male predominance of infection in children younger
than 3 years, which switches to a female predominance in children older than
3 years. In adults, no difference in rates of infection between men and women
is apparent.
 Race-related demographics
No differences among different races with respect to susceptibility to RV
infection or disease course have been described. In general, Native Americans
and Eskimos are more likely to develop the common cold and appear to have
higher rates of complications such as otitis media. These findings may be
explained as much by environmental conditions (eg, poverty and
overcrowding) as by ethnicity.

Physiology
 RV possesses various transmission modes and can infect a huge population at
any given time. Most commonly, RVs are transmitted to susceptible
individuals through direct contact or via aerosol particles. The primary site of
inoculation is the nasal mucosa, though the conjunctiva may be involved to a
lesser extent. RV attaches to respiratory epithelium and spreads locally. The
major human RV receptor is ICAM-1 (found in high quantities in the
posterior nasopharynx).
 Highly contagious behavior includes nose blowing, sneezing, and physically
transferring infected secretions onto environmental surfaces or paper tissue.
Contrary to popular belief, behaviors such as kissing, talking, coughing, or
even drooling do not contribute substantially to the spread of disease.
 Infection rates approximate 50% within the household and range from 0% to
50% within schools, indicating that transmission requires long-term contact
with infected individuals. Brief exposures to others in places such as movie
theaters, shopping malls, friends’ houses, or doctors’ offices are associated
with a low risk of transmission. Because children produce antibodies to fewer
serotypes, those who attend school are the most common reservoirs of RV
infection.

Signs and Symptoms
Most people get colds in the winter and spring, but it is
possible to get a cold at any time of the year. Symptoms
usually include sore throat, runny nose, coughing,
sneezing, watery eyes, headaches and body aches. Most
people recover within about 7-10 days. However,
people with weakened immune systems, asthma, or
respiratory conditions may develop serious illness, such
as pneumonia.

Organs Affected
 Colds are usually harmless and clear up without any serious
consequences. But bacteria can sometimes spread through the
airways after a viral infection, and they may cause more severe
problems in different places, such as in the sinuses. An infection
in your voice box (larynx) can cause you to lose your voice. In
babies, infants and young children, colds sometimes spread to
the ear and cause a middle ear infection. Bacterial infections in
the throat can cause a sore throat or tonsillitis.
 Infections of the upper airways very rarely cause serious
complications like pneumonia. It is a good idea to see a doctor if
you have high fever, severe or worsening symptoms, chest pain,
shortness of breath or trouble breathing. This is especially
important for people who have a chronic disease of the airways,
such as chronic obstructive pulmonary disease (COPD).

Case Study
 In August and September of 2014, there was an outbreak of an acute
respiratory infection (ARI) among the first and second year students at
Harvard Medical School and Harvard School of Dental Medicine. Out of
400 students, 74% (296) completed an anonymous retrospective survey
concerning their recent health. Of the respondents, 34% of second year (57
of 167) and 25% of first year (33 of 129) students reported experiencing an
acute illness over the preceding month. 94% (278 of 296) of the recently ill
students reported experiencing one or several ARI symptoms, including
nasal congestion, cough, sore throat, and nasal discharge. Incidence data
were compiled from self-reported dates of when respondents first began
feeling ill

Cont.
 Among the 296 respondents to a retrospective survey, 90 students (30%) reported
symptoms of an acute illness over a month-long period. 34% of second-year (57 of 167)
and 25% of first-year (33 of 129) medical and dental students reported experiencing an
acute illness over the previous month.
 The rhinovirus displays season-dependent transmission, and during its peak in autumn, the
pathogen causes up to 80% of colds (Arrudaet al., 1997). Together the coronaviruses,
respiratory syncytial viruses (RSVs), and parainfluenza viruses, adenoviruses and
enteroviruses account for around 35% of colds (Fendrick et al., 2003). Influenza viruses
cause around 5%–15% of colds. Because the common cold is defined on the basis of its
clinical presentation, a mild influenza infection can accurately be diagnosed as a cold,
meaning that the two infections are not completely distinct disease entities (Heikkinen and
Jarvinen, 2003). It is suspected that yet-unidentified viruses explain the remaining 20%–
30% of the cases of the cold.

 The RV is inhaled directly or finds its way to the nassal passage through
hands that are contaminated with the virus. The virus is then transported to
the back of the nose by the regular functioning of the nose itself. Here, the
RV attaches itself to the receptors at the surface of the nasal cells, where it
reproduces. These receptors are called Intercellular Adhesion Molecule-
1(ICAM- 1). The reproductive cycle of the RV is 8-12 hours long. Once the
cells have been attacked, in the infected cells, the virus replicates as rapidly as
possible, and continually sheds progeny viruses. These progeny viruses can
propagate the infection by invading neighboring cells.
 The infection remains localized in the upper respiratory tract. This occurs for
one very important reason: rhinoviruses are extremely inefficient replicators
at temperatures above 33°C. The virus may find its way to the lower portion
of the lungs, but temperatures there are several degress warmer
(approximately 37°C) and are not conducive to rhinoviral infection. The virus
can also be swallowed and end up in the stomach where both increased
temperature and decreased pH work to prevent infection. Unlike poliovirus,
the rhinovirus capsid irreversibly disassembles at low pH, effectively
inactivating the virus.

Mode of Entry
Many different viruses can cause the common cold, but
rhinoviruses are the most common. Viruses that cause
colds can spread from infected people to others
through the air and close personal contact. You can
also get infected through contact with stool or
respiratory secretions from an infected person. This can
happen when you shake hands with someone who has a
cold, or touch a doorknob that has viruses on it, then
touch your eyes, mouth, or nose.

Natural Remedy
 Turn Up the Heat
 Stay Hydrated
 Soothe Your Skin
 Gargle Salt Water
 Consider Supplements
 Prevent the Spread

Medical Management
There's no cure for the common cold. Antibiotics are of no use against cold
viruses. Over-the-counter (OTC) cold preparations won't cure a common
cold or make it go away any sooner, and most have side effects.
 Pain relievers
 Decongestant nasal sprays
 Cough syrups

Nursing Intervention
 Pain Management
 Administer analgesics, as indicated
 Energy Management: Regulating energy use to treat or prevent fatigue and optimize function
 Exercise Promotion: Facilitation of regular physical exercise to maintain or advance to a higher
level of fitness and health
 Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids
 Temperature Regulation: Attaining and/or maintaining body temperature within a normal range.
 Fever Treatment: Management of a patient with hyperpyrexia caused by nonenvironmental
factors.
 Malignant Hyperthermia Precautions: Prevention or reduction of hypermetabolic response to
pharmacological agents used during surgery
 Maintain airway patency.
 Expectorate/clear secretions readily.
 Demonstrate absence/reduction of congestion with breath sounds clear, respirations noiseless,
improved oxygen exchange
 Infection Protection: Prevention and early detection of infection in a patient at risk
 Infection Control: Minimizing the acquisition and transmission of infectious agents
 Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for
clinical decision making

Expected Outcome
(natural remedy)
 Turn Up the Heat
When a cold strikes, chicken soup and hot tea can ease your
symptoms. The reason: heat. As the warmth moves down your throat
toward your stomach, it helps loosen mucus, making it easier
to cough out.
Steam works the same way. Sitting in the bathroom with a hot shower
running can relieve your stuffy nose and head.
 Stay Hydrated
When you have a cold, your body makes more mucus. Making mucus
uses up your body's moisture.
Getting extra fluids thins out mucus and makes it less sticky, which
makes it easier blow or cough out. Limit drinks with caffeine and
alcohol, as they can be dehydrating.
 Soothe Your Skin
You blow your nose a lot when you have a cold. The result can be red,
chapped skin on and beneath your nose.
Add a dab of petroleum jelly to the raw area, or use facial tissues that
contain lotion.

cont.
 Gargle Salt Water
If you have a sore throat, make a salt-water gargle by mixing a teaspoon of
salt in a small glass of warm water. The salty-warm combo provides short-
term relief.
 Consider Supplements
Some supplements have been found to shorten -- but not cure -- colds.
Ask your doctor about zinc, vitamin C, and echinacea.
Tell your doctor before starting any new supplement or medication. Your
doctor will make sure it won't interact with any other drug you're taking.
 Prevent the Spread
You should stay home while you're getting over your cold. If you have to
go out, try to limit the number of people you come in contact with.
Cover your mouth with the inside of your elbow when you cough or
sneeze to keep from getting germs on your hands. A little courtesy goes a
long way.
Hang in there. The common cold usually goes away in about a week, so
take it easy, take care of yourself, and you’ll be back to normal before you
know it.

Expected outcome
(medical management)
 Pain relievers. For fever, sore throat and headache, many people turn
to acetaminophen (Tylenol, others) or other mild pain relievers. Keep
in mind that acetaminophen can cause liver damage, especially if taken
frequently or in larger than recommended doses. Don't give
acetaminophen to children under 3 months of age, and be especially
careful when giving acetaminophen to older babies and children
because the dosing guidelines can be confusing. For instance, the
infant-drop formulation is much more concentrated than the syrup
commonly used in older children. Use caution when giving aspirin to
children or teenagers. Though aspirin is approved for use in children
older than age 2, children and teenagers recovering from chickenpox or
flu-like symptoms should never take aspirin. This is because aspirin has
been linked to Reye's syndrome, a rare but potentially life-threatening
condition, in such children.

Cont.
 Decongestant nasal sprays. Adults shouldn't use decongestant
drops or sprays for more than a few days because prolonged use
can cause chronic rebound inflammation of mucous membranes.
And children shouldn't use decongestant drops or sprays at all.
There's little evidence that they work in young children, and they
may cause side effects.
 Cough syrups. The Food and Drug Administration (FDA) and the
American Academy of Pediatrics strongly recommend against
giving OTC cough and cold medicines to children younger than age
2. Over-the-counter cough and cold medicines don't effectively
treat the underlying cause of a child's cold, and won't cure a child's
cold or make it go away any sooner. These medications also have
potential side effects, including rapid heart rate and convulsions.

Thank you!
By:
Banua, Jashmir Joyce V.
Cervas, Khristine Nikolae R.

Rhinovirus

In this document

More Related Content

What's hot

Viewers also liked

Similar to Rhinovirus

Recently uploaded

Rhinovirus