Infectious Diseases A to Z – Rhinovirus

With this new column, Elite Healthcare will compile an index of various infectious diseases, with occasional highlights of emerging conditions.

Rhinovirus

General definition and information:

The most common cause of the “common cold,” and as such the most common viral agent among humans, rhinoviruses represent a variety of picornaviruses, a large family of small, cytoplasmic viruses found in mammals and birds. This family of viruses is also responsible for conditions such as poliomyelitis, hepatitis A, foot-and-mouth disease, and others.1 Associated complications also include ear infections, asthma, sinusitis and other secondary infections such as strep throat, pneumonia, croup, and bronchiolitis. Symptoms will include the gamut of telltale signs of any cold, notably a runny or stuffy nose, sore throat, cough, congestion, body aches and headaches, sneezing, fever, and general malaise. The likelihood of serious long-term complications and death are rare, but rhinoviruses can indeed be fatal among patients who are already living with severe chronic diseases such as COPD, asthma, or cancer.2,3

SIDEBAR

Has A “Weakness” Been Found Among Common Cold Viruses?

Scientists who have discovered an indentation on the surface of the viruses that cause many illnesses, including the common cold, believe they could have set the stage for better treatment of colds and other illnesses, including polio, due to a vulnerability, “a weak spot,” found on the viruses. According to a report by News Medical, an open-access medical journal, a new study published in PLOS Biology by authors from the University of Leuven, Belgium, and colleagues from the University of Helsinki, explains that when testing antiviral compounds, one particular compound was found to bind to a pocket that was then discovered to be common among picornaviruses. The pocket is an “excellent target for antivirals,” and “is essential to identify key working components” in order to find target points in the viruses for drugs to take advantage of, according to the report. The compound was then used to create a number of variants of the antiviral molecule to test against a range of picornaviruses, and the researchers who wrote the study consider that the virus may mutate and make the vulnerable pocket on the protein shell resistant to the newly developed compounds, according to the report. Research into making compounds into effective medications continues, and the researchers reportedly believe that the indentation on the shell could still make the drug “resistance proof” by making replicated viral particles less effective, despite the encouraging findings.

Causes & Modes of Transmission:

 A cold virus enters the body by mouth, eyes, or nose and can spread through droplets in the air when someone who is sick coughs, sneezes, or even talks, according to the Mayo Clinic. Viruses also spread by hand-to-hand contact and sharing contaminated objects. Additional risk factors for contracting a cold virus include age (highest risk are children younger than 6 years), having an already weakened immune system due to chronic illness or other reasons, time of year (fall and winter months see increased illnesses), smoking, and increased general exposure due to occupation or living arrangements, such as a college campus, or time spent on an airplane or other public transportation.

Treatment Strategies:

With no cure for the common cold, although some scientists have recently claimed to have found a weakness in the virus (see sidebar), healthcare providers should encourage patients to rest and drink plenty of fluids. Over-the-counter medications such as pain relievers, cough syrups, and decongestant nasal sprays may also be effective in alleviating symptoms, but parents should be cautioned over the inappropriate use of OTC drugs with babies and young children.4 Popular “alternative medicine” choices include vitamin C, Echinacea, and zinc, all of which work to varying degrees, may cause side effects, and should be used with appropriate physician supervision.4 Mayo Clinic officials also suggest the potential of eating chicken soup and other warm fluids to soothe and loosen congestion, adjusting temperature and humidity in the house, saltwater gargling, and using saline nasal drops.

 Prevention Parameters:

 Prevention of the spread of cold viruses includes taking steps to protect oneself as well as trying to protect others, according to the Centers for Disease Control and Prevention (CDC). Healthcare providers should promote regular washing of hands with soap and water, avoiding the touching of one’s eyes, nose, and mouth as much as possible, avoiding those who are known to be sick, and practicing “cough and sneeze etiquette”: use a tissue or upper shirt sleeve and completely cover the mouth and nose.

Those who know that they have an active cold should stay at home (and keep children out of school or daycare if they are sick); avoid close contact with others; move away from others before coughing or sneezing; dispose of used tissues; wash their hands after coughing, sneezing, or blowing their nose; and disinfect frequently touched surfaces and objects.

 Additionally, the CDC advises healthcare providers to help their patients know the difference between the common cold and the flu by seeing their doctor when they are not feeling well so that they can be diagnosed and reminds providers that yearly flu vaccination should be discussed with patients.

 References

  1. Tuthill TJ, Groppelli E, Hogle JM, Rowlands DJ. Picornaviruses. Curr Top Microbiol Immunol. 2010;343:43-89.
  2. Greenberg SB. Respiratory consequences of rhinovirus infection. Arch Intern Med. 2003;163(3):278-84.
  3. Hai L, Bich V, Ngai L, et al. Fatal respiratory infections associated with rhinovirus outbreak, vietnam. Emerging Infectious Diseases. 2012;18(11):1886-8.
  4. Common cold. Mayo Clinic. 2019. Accessed online: www.mayoclinic.org/diseases-conditions/common-cold/diagnosis-treatment/drc-20351611

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