Human Rhinovirus: The Most Common of the Common Colds

The only certainties in life are death and taxes—and the common cold. In fact, adults can expect to experience two or three colds every single year.¹ Many pathogens can cause cold symptoms. But the most frequent culprit are human rhinoviruses.²

Human rhinoviruses cause more than half of cold-like illnesses.² They circulate throughout the world and throughout the year, resulting in untold medical expense and lost productivity. Although colds tend to be relatively minor illnesses, they are the most frequent cause of lost work or school days.¹ The indirect and direct costs of non-influenza respiratory infections have been estimated at $40 billion each year in the US.³

Rhinoviruses and enteroviruses

Rhinoviruses belong to the enterovirus genus within the Picornaviridae family. There are more than 100 serotypes of human rhinovirus, complicating any efforts to create a vaccine or effective antivirals.² Enteroviruses encompass four human species that include at least 89 distinct types—each of which can be associated with different illnesses and symptoms throughout the body, including cold-like respiratory illnesses.⁴

There is cross-reactivity between polymerase chain reaction (PCR) assays for human rhinovirus and enterovirus, making differentiation difficult.² Because of this, they are generally reported together in PCR testing.

Doctor examining coughing young woman at clinic

Human rhinovirus symptoms and severity

In most cases, human rhinoviruses cause mild upper respiratory tract infections. Symptoms are similar to those caused by other respiratory pathogens and may include sore throat, runny nose, coughing, sneezing, and headaches. No approved antiviral therapies exist for human rhinoviruses. Instead, treatment involves supportive care, including over-the-counter medications that may provide some relief for symptoms, which can persist for 7 to 10 days.¹

While human rhinoviruses are generally considered upper respiratory viruses, there is a growing awareness that these viruses can cause infections in the lower respiratory tract as well, particularly for infants, the elderly, immunocompromised patients, and those with asthma.²

In fact, for immunocompromised patients—including children with asthma and adults with COPD—a human rhinovirus infection can lead to more severe illness, including an influenza-like illness, pneumonia, chronic infections, and secondary bacterial infections.² One study found that human rhinovirus is the second most common cause of bronchiolitis in hospitalized children (after respiratory syncytial virus).⁵

Avoiding and treating human rhinovirus

Like many respiratory pathogens, human rhinoviruses are transmitted through contact with contaminated surfaces, including skin, or aerosolized in the air.²

To reduce your risk of becoming infected with a human rhinovirus, wash your hands frequently and avoid touching your mouth, nose, or eyes. If you are sick, help protect others by staying home from work, keeping sick children home from school, avoiding close contact with others, and washing your hands after coughing, sneezing, or blowing your nose.

Antibiotics are ineffective against viral infections. The best remedy for the common cold is resting and drinking plenty of fluids, although symptoms may be alleviated with over-the-counter medications.¹

It’s important to know when to seek medical care, since a human rhinovirus infection can lead to complications for children, the elderly, and immunocompromised individuals. Call your doctor if symptoms persist for longer than 10 days or if you have severe or unusual symptoms. Those at high risk for flu complications—children younger than 5, adults 65 years or older, pregnant women, and people with medical conditions like asthma, diabetes, and heart disease—should seek immediate care if they develop flu symptoms like fever, chills, and body aches.¹

Identifying human rhinovirus with the syndromic testing approach

When a patient presents with severe cold-like or flu-like symptoms, it is impossible to know what’s causing the illness without diagnostic testing. That’s because many respiratory pathogens cause similar, overlapping symptoms. A child with severe respiratory symptoms, for example, could have human rhinovirus, COVID-19, influenza, respiratory syncytial virus, or another respiratory pathogen.

Syndromic infectious disease testing from BioFire can help deliver answers—fast. The BioFire Respiratory 2.1 (RP2.1) Panel identifies 22 of the most common respiratory pathogens, including human rhinovirus/enterovirus, with results in about 45 minutes. The BioFire RP2.1 Panel utilizes nasopharyngeal swabs, the CDC-recommended sample type for detection of upper respiratory tract infections.

For lower-tract infections, the BioFire^® FilmArray^® Pneumonia (PN) Panel identifies 33 clinically relevant targets, including bacteria, viruses, and antimicrobial resistance genes, in about an hour. The BioFire PN Panel zeros in on the lower respiratory tract by utilizing sputum (including endotracheal aspirate) or bronchoalveolar lavage (including mini-BAL) samples.

Fast and comprehensive results from either the BioFire RP2.1 Panel or the BioFire PN Panel can help inform rapid diagnosis and treatment decisions. Pneumonia patients, in particular, are often over-treated with antibiotics while clinicians await the results of diagnostic testing.⁶ Rapid answers can help avoid or reduce unnecessary antibiotics, while also enabling clinicians to make crucial decisions about admission, isolation, cohorting, and additional diagnostic testing.

Respiratory 2.1 syndromic testing panel.

A Point-of-Care Solution

When it comes to respiratory infections—even viral colds—using a comprehensive respiratory panel can give clinicians the information they need to help set patient expectations and manage their patients appropriately.

Point-of-care clinics, such as urgent care centers, pediatric offices, and family physicians, frequently see patients suffering from respiratory illnesses for which antibiotics are neither effective nor recommended.⁷ The BioFire^® Respiratory 2.1-EZ (RP2.1-EZ) Panel (EUA)* offers rapid and comprehensive results for patients suspected of COVID-19, giving clinicians the information they need to target therapy appropriately—and discuss the efficacy of antibiotics with their patients.

The BioFire RP2.1-EZ Panel (EUA) detects 19 common respiratory pathogens, including human rhinovirus/enterovirus, SARS-CoV-2, influenza, respiratory syncytial virus, and more. The BioFire RP2.1-EZ Panel (EUA) is authorized for use at the point of care (POC) in patient care settings operating under a CLIA Certificate of Waiver, Certificate of Compliance, or Certificate of Accreditation.

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References:

Common Colds: Protect Yourself and Others. Access on 09 Sept 2021. Retrieved from: https://www.cdc.gov/features/rhinoviruses/index.html
Jacobs SE, et al. Clin Microbiol Rev. 2013;26(1):135-162.
Fendrick AM, et al. Arch Intern Med. 2003 Feb 24; 163(4):487-94.
BioFire^® Respiratory 2.1 Panel Instructions for Use.
Mansbach JM, et al. Arch Pediatr Adolesc Med. 2012 Aug; 166(8):700-6.
Buchan BW, et al. American Thoracic Society Conference. Poster. 20 May 2018, San Diego CA.
Antibiotic Use in Urgent Care Centers Shows Need for Improvement. Issue Brief. 16 July 2018. Retrieved from: https://www.pewtrusts.org/en/research-and-analysis/issue-briefs/2018/07/antibiotic-use-in-urgent-care-centers-shows-need-for-improvement

*This product has not been FDA cleared or approved, but has been authorized for emergency use by FDA under an EUA for use by authorized laboratories;
*This product has been authorized only for the detection and differentiation of nucleic acid of SARS-CoV-2 from multiple respiratory viral and bacterial organisms; and,
*The emergency use of this product is only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. § 360bbb-3(b)(1), unless the declaration is terminated or authorization is revoked sooner.