Human Rhinovirus: Symptoms & Testing

Human rhinoviruses are the most frequent etiologic agent of acute nasopharyngitis in adults. Though the common cold is a self-limiting viral infection, the identification and therapeutic intervention of the viruses causing infection can present a clinical challenge for both patients and health care providers. Accurate diagnostics and testing are crucial for the identification of the virus and the therapeutic intervention of infected patients.

About Rhinoviruses

Rhinoviruses are small, nonenveloped RNA viruses of the Enterovirus genus and Picornaviridae family, comprising three species and over 160 serotypes with different surface antigens. The virus has a single-stranded RNA genome, with its nucleotides enclosed in an icosahedral capsid. The high number of serotypes and limited immunity across these complicates the development of antiviral drugs and vaccines, contributing to the high prevalence of infection. Infection-induced immunity for rhinoviruses is specific to a particular serotype, has variable effectiveness in disease prevention, and does not provide long-lasting protection.

Rhinovirus and Enterovirus Symptoms and Severity

The virus incubates between one and three days before the patient displays clinical manifestations. Rhinoviruses primarily affect the upper respiratory tract, particularly the nasopharynx and nose, causing infected individuals to present with clinical manifestations such as:

Rhinorrhea
Sternutation
Pharyngitis
Cephalalgia
Cough
Nasal mucosal edema
Malaise
Loss of appetite
Myalgia

Rhinoviruses are more likely to cause severe complications and disease in vulnerable populations, including:

Immunocompromised individuals
Infants and children
Pregnant women
The elderly
Individuals with medical conditions like heart disease and diabetes

In some cases, rhinoviruses have a role in acute exacerbations of respiratory and reactive airway diseases like asthma and chronic obstructive pulmonary disease (COPD). As the virus spreads from the throat and nose to the lower respiratory tract, middle ear, and sinuses, it can cause:

Lower respiratory tract infections
Chronic bronchiolitis
Chronic infections
Otitis media
Laryngitis
Pneumonia
Secondary bacterial infections
Sinusitis

Human Rhinovirus Treatment and Prevention Options

Since the human rhinovirus primarily impacts the respiratory system, the modes of transmission include respiratory droplet aerosols, contact with fomites, and person-to-person contact. Rhinoviruses can survive on many surface types for prolonged periods, facilitating contagion across the population.

Preventive measures to reduce the risk of infection include:

Handwashing with soap and water frequently.
Not touching portals of entry, such as the eyes, nose, and mouth.
Wearing a mask in public spaces.
Coughing and sneezing into a bent elbow or tissue.

Infected individuals can take the following measures to reduce the chance of spreading the virus to others:

Wash hands after blowing the nose, sneezing, and coughing.
Avoid close contact with or isolate from household members.
Stay home from school, work, and other public venues until remission.

Antiviral treatments and vaccines for rhinovirus infection do not yet exist, since there is a limited level of cross-protection among the serotypes. Antibiotics are ineffective against viral colds, so they are not a recommended therapeutic intervention for rhinovirus infections. Treatment involves supportive therapeutic interventions to alleviate discomfort caused by clinical manifestations. Common remedies include:

Getting adequate rest.
Maintaining hydration by drinking water, tea, and other fluids.
Taking over-the-counter medications.

Medical care may be warranted in some cases, as human rhinovirus infection can cause health complications. Immediate care from a health professional is required when:

The virus causes severe complications.
Clinical manifestations persist for over 10 days.
The patient is high-risk.
The patient develops flu-like symptoms, such as myalgia, rigors, and pyrexia.

Challenges of Assays for Human Rhinoviruses and Enteroviruses

A patient is diagnosed with a rhinovirus infection based on the results of a physical examination and review of their medical history by a medical professional. However, rhinoviruses present similar clinical manifestations to parainfluenza, coronaviruses, and adenoviruses, so health care providers use assays for differential diagnosis.

Rhinoviruses can be diagnosed using a polymerase chain reaction (PCR) test, which targets the RNA sequences that most serotypes have in common. However, their close genetic relationship and cross-reactivity between PCR assays for enteroviruses and rhinoviruses present challenges in differentiation, so they are often reported together. Rhinovirus/enterovirus positive results may occur for prolonged periods, even when the patient is asymptomatic.

How the Syndromic Testing Approach Identifies Human Rhinovirus

Since various respiratory illnesses present similar symptoms, diagnostic testing is required to determine the specific virus or bacteria causing a patient’s common cold clinical manifestations. Syndromic infectious disease testing is a fast and effective epidemiological methodology for accurate diagnosis. This approach utilizes a single test to simultaneously target multiple pathogens with similar and overlapping clinical manifestations.

Syndromic panels utilize PCR technology to isolate and amplify nucleic acids and detect DNA to identify targets present in the patient sample. Nucleic acid amplification is a common method used for human rhinovirus detection due to its sensitivity, rapidity, and specificity.

The BioCode^® Respiratory Pathogen Panel is a qualitative multiplexed assay capable of detecting 17 microbial pathogens in a single reaction. This in vitro diagnostic test simultaneously detects and identifies nucleic acids from numerous bacterial pathogens and viruses that can cause respiratory tract infections, including:

Rhinovirus enterovirus
Adenovirus
Parainfluenza 1, 2, 3, and 4
Respiratory syncytial virus A/B
Influenza A and B
Coronavirus
Human metapneumovirus A/B
Mycoplasma pneumoniae
Chlamydia pneumoniae
Bordetella pertussis

Samples are obtained from patients exhibiting clinical manifestations of a respiratory tract infection using a nasopharyngeal swab. If any of the targeted pathogens or their subtypes are detected, a rhinovirus/enterovirus positive result is reported.

Our assay delivers timely results, allowing health care providers to quickly identify the specific pathogen to guide accurate diagnosis and appropriate therapeutic intervention decisions. Data masking enables selective target reporting based on a health care professional’s order, benefiting the clinic and patient.

The assay is U.S. FDA 510(K) cleared and can be used in parallel testing with other FDA-cleared BioCode^® assays.

Use BioCode^® Respiratory Pathogen Panel to Detect Rhino Enterovirus and Other Pathogens

Comprehensive respiratory panels, such as the BioCode^® Respiratory Pathogen Panel, are crucial in human rhinovirus treatment and diagnostics. Our assay provides essential information to health care providers in urgent care, medical offices, and pediatric offices. Test results enable them to identify the etiology of their patients’ respiratory illness, determine an effective therapeutic intervention plan, manage patient expectations, and avoid prescribing unnecessary and ineffective antibiotics.

Contact Applied BioCode Inc. for more information about the Respiratory Pathogen Panel’s diagnostic capabilities.