Rhinovirus

The rhinovirus (from the Greek ῥίς rhis 'nose', .mw-parser-output .smallcaps{font-variant:small-caps}gen ῥινός rhinos 'of the nose', and the Latin vīrus) is the most common viral infectious agent in humans and is the predominant cause of the common cold. Rhinovirus infection proliferates in temperatures of 33–35 °C (91–95 °F), the temperatures found in the nose. Rhinoviruses belong to the genus Enterovirus in the family Picornaviridae. The rhinovirus (from the Greek ῥίς rhis 'nose', .mw-parser-output .smallcaps{font-variant:small-caps}gen ῥινός rhinos 'of the nose', and the Latin vīrus) is the most common viral infectious agent in humans and is the predominant cause of the common cold. Rhinovirus infection proliferates in temperatures of 33–35 °C (91–95 °F), the temperatures found in the nose. Rhinoviruses belong to the genus Enterovirus in the family Picornaviridae. The three species of rhinovirus (A, B, and C) include around 160 recognized types of human rhinoviruses that differ according to their surface proteins (serotypes). They are lytic in nature and are among the smallest viruses, with diameters of about 30 nanometers. By comparison, other viruses, such as smallpox and vaccinia, are around 10 times larger at about 300 nanometers; while flu viruses are around 80–120 nm. There are two modes of transmission: via aerosols of respiratory droplets and from fomites (contaminated surfaces), including direct person-to-person contact. Rhinoviruses are spread worldwide and are the primary cause of the common cold. Symptoms include sore throat, runny nose, nasal congestion, sneezing and cough; sometimes accompanied by muscle aches, fatigue, malaise, headache, muscle weakness, or loss of appetite. Fever and extreme exhaustion are more usual in influenza. Children may have six to twelve colds a year. In the United States, the incidence of colds is higher in the autumn and winter, with most infections occurring between September to April. The seasonality may be due to the start of the school year and to people spending more time indoors (thus in proximity with each other), thereby increasing the chance of transmission of the virus. Lower ambient, especially outdoor, temperatures may also be factor given that rhinoviruses preferentially replicate at 32 °C (89 °F) as opposed to 37 °C (98 °F) – see following section. Variant pollens, grasses, hays and agricultural practices may be factors in the seasonality as well as the use of chemical controls of lawn, paddock and sportsfields in schools and communities. The changes in temperature, humidity and wind patterns seem to be factors. It is also postulated that poor housing, overcrowding and unsanitary conditions related to poverty are relevant factors in the transmission of 'common cold'. Those most affected by rhinoviruses are infants, the elderly, and immunocompromised people. The primary route of entry for human rhinoviruses is the upper respiratory tract (mouth and nose). Rhinovirus A and B bind to ICAM-1 (Inter-Cellular Adhesion Molecule 1) also known as CD54 (Cluster of Differentiation 54) receptors on respiratory epithelial cells while rhinovirus C uses cadherin-related family member 3 (CDHR3) to mediate cellular entry. As the virus replicates and spreads, infected cells release distress signals known as chemokines and cytokines (which in turn activate inflammatory mediators). Cell lysis occurs at the upper respiratory epithelium. Infection occurs rapidly, with the virus adhering to surface receptors within 15 minutes of entering the respiratory tract. High-risk individuals include children and the elderly. Just over 50% of individuals will experience symptoms within 2 days of infection. Only about 5% of cases will have an incubation period of less than 20 hours, and, at the other extreme, it is expected that 5% of cases would have an incubation period of greater than four and a half days. Human rhinoviruses preferentially grow at 32 °C (89 °F), notably colder than the average human body temperature of 37 °C (98 °F); hence the virus's tendency to infect the upper respiratory tract, where respiratory airflow is in continual contact with the (colder) extrasomatic environment. Rhinovirus C, unlike the A and B species, may be able to cause severe infections. This association disappears after controlling for confounders. Duly, amongst infants infected with symtomatic respiratory illness in low-resource areas, there appears to be no association between rhinovirus species and disease severity.