Clinical, virological and epidemiological characteristics of rhinovirus infections in early childhood: A comparison between non-hospitalised and hospitalised children

Abstract

Background: Several studies have been published regarding the epidemiology and clinical significance of the different rhinovirus (RV) species (-A, -B and -C). However, data on RV types and the associations with clinical outcome in young children are limited. Here, we investigated the clinical, virological and epidemiological characteristics of RV infections in young children with mild or asymptomatic infection (non-hospitalised children) and in symptomatic young children admitted to the hospital.

Objectives: The aim of this study was to evaluate associations between different characteristics of RV infections and clinical outcome in young children.

Study design: RV-infected children were retrospectively selected from a Dutch birth cohort (EUROPA-study) and from hospitalised children admitted to the hospital because of respiratory symptoms. In total 120 RV-typed samples could be selected from 65 non-hospitalised and 49 hospitalised children between November 2009 and December 2012.

Results: RV-A was the predominant species in both study populations, followed closely by RV-C. RV-B was observed only sporadically. The distribution of the RV species was comparable in non-hospitalised and hospitalised children. In children with respiratory distress who required ICU-admission the distribution of RV species did not differ significantly from the non-hospitalised children. No predominant RV type was present in non-hospitalised nor hospitalised children. However, hospitalised children were younger, had more often an underlying illness, a higher RV load and more frequently a bacterial co-infection.

Conclusions: Clinical outcome of RV infected young children was not related to RV species or types, but may more likely be influenced by multiple (host-specific) factors.

Keywords: Clinical outcome; Epidemiology; Respiratory tract infection; Rhinovirus.

Fig. 1

Distribution of RV species in non-hospitalised, hospitalised and ICU-admitted children. Distribution of RV species was comparable in all populations.

Fig. 2

Frequency of RV types. For each species the prevalence of detected types in both populations is illustrated. White bars indicate non-hospitalised children and shaded bars indicate hospitalised children.

Fig. 3

Seasonal distribution of RV species. Stacked bars indicate the seasonal distribution of RV species.

Fig. 4

Circulation of RV types in non-hospitalised and hospitalised children. The x-axis indicates the study period and the y-axis indicates the detected types from corresponding species detected during study period. White diamonds indicate non-hospitalised patients and black circles indicate hospitalised children.