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Human rhinoviruses (HRVs) are traditionally associated with ‘common cold’ upper respiratory tract infection, otitis media, and sinusitis. However, the advent of PCR testing for respiratory specimens has clearly demonstrated causation of lower respiratory tract infection as well. HRV can be a serious pathogen in children, immunocompromised hosts, and chronic pulmonary disease patients.

HRV is in the genus Enterovirus, has 3 genetically distinct groups and more than 100 serotypes, which baffles efforts at anti-viral drug and vaccine development. HRV is transmitted by either person to person contact, contact with contaminated surfaces or aerosols. This is a hardy virus group that can survive on indoor surfaces for days at ambient temperature & on uncleansed skin for 2 hours. Most infections occur in spring, summer, & fall months, while influenza & RSV predominate in winter. Symptoms associated with HRV can be clinically indistinguishable from those caused by coronavirus, which is the second most common ‘cold’ virus.

Exacerbations of chronic obstructive pulmonary disease and asthma, severe bronchiolitis in children, and fatal pneumonia in the elderly & immunocompromised are now known to be within HRVs’ spectrum of illness. Stem cell transplant, lung transplant & those with hematopoietic malignancies and cystic fibrosis are the most vulnerable to severe lower respiratory tract HRV infections among immunocompromised patients. Morbidity & mortality in long-term care facilities due to HRV community-acquired pneumonia has been recently reported.

Hand hygiene and adherence to institutional isolation policies are crucial to limiting the potential transmission of HRV within health-care facilities.

Respiratory PCR is much more sensitive than rapid antigen tests. Sensitivity of PCR for the eight most common respiratory viruses ranges from 95 to100%, with specificity of 99 to100%.

Testing can be performed on nasopharyngeal swabs, nasal washes and bronchoscopy specimens. For optimal results, specimens should be collected within 3 to 5 days of symptom onset

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