Can adults have rhinovirus infections?

Rhinovirus Infections in Adults

Yes, adults can definitely have rhinovirus infections. Rhinoviruses are well-established pathogens that affect adults of all ages, causing both upper and lower respiratory tract infections with varying degrees of severity. 1, 2

Clinical Presentation in Adults

• Rhinovirus infections in adults typically present with upper respiratory symptoms including nasal discharge, nasal congestion, sneezing, sore throat, cough, postnasal drip, facial pressure, and sometimes hyposmia/anosmia 1, 3
• The symptom pattern follows a predictable course with three main patterns: (1) fever and myalgia; (2) sneezing and sore throat; and (3) cough and rhinorrhea, which can persist longer 1
• Symptoms typically last 7-10 days, but cough may persist for up to 10 days or longer in some cases 3
• Approximately 7-13% of adults may experience symptoms lasting more than 15 days 3

Epidemiology and Transmission

• Rhinovirus is highly infectious and easily transmitted through aerosols and direct contact 2
• Peak incidence occurs in autumn and spring in temperate climates, though circulation occurs year-round 2
• Adults typically experience 2-5 episodes of viral acute respiratory infections (including rhinovirus) per year 1
• Rhinovirus consistently ranks among the most prevalent respiratory pathogens detected in adults globally 2
• During the SARS-CoV-2 pandemic, rhinovirus transmission persisted despite public health measures, demonstrating its high transmissibility 2

Complications and Severity

• While most rhinovirus infections cause self-limiting upper respiratory tract symptoms, they can lead to more serious lower respiratory tract infections in certain populations 1, 2
• Adults with underlying conditions such as asthma, COPD, or immunocompromised states are at higher risk for severe rhinovirus infections 1, 4, 5
• Rhinovirus can trigger exacerbations of chronic airway diseases such as asthma and COPD 2
• In elderly and frail adults, rhinovirus infections can lead to serious respiratory illnesses requiring hospitalization 6
• A study of hospitalized elderly adults found that 12% of patients with cardiopulmonary illnesses had rhinovirus or coronavirus identified, with some developing pneumonia and requiring respiratory support 6

Diagnosis

• Diagnosis is typically clinical, based on characteristic symptoms 3
• Modern molecular techniques like PCR have enhanced detection of rhinovirus and revealed greater genetic diversity than previously recognized 4, 2
• Rhinovirus comprises three species and more than 170 genotypes, contributing to its ability to evade immune responses 2
• Multiplex PCR assays are available to detect rhinovirus and other respiratory viruses in clinical settings 1

Management

• Most rhinovirus infections are self-limiting and resolve without specific antiviral treatment 3
• Antibiotics are not effective for uncomplicated rhinovirus infections as they are viral in nature 1, 3
• Bacterial superinfection occurs in less than 2% of cases 3
• Consider bacterial superinfection if symptoms worsen after 5-7 days or persist beyond 10 days with severe unilateral pain, high fever, or "double sickening" (deterioration after initial improvement) 1, 3
• Supportive care is the mainstay of treatment, focusing on symptom relief 3

Clinical Implications

• The burden of rhinovirus infections in adults extends across various healthcare settings, from primary care to hospital wards and intensive care units 2
• The impact of rhinovirus on adult morbidity and healthcare utilization rivals that of other major respiratory viruses, including influenza and respiratory syncytial virus 2
• The extensive genetic diversity of rhinovirus poses challenges for vaccine development and antiviral therapies 2

In conclusion, rhinovirus infections are common in adults and can range from mild upper respiratory symptoms to severe lower respiratory illness, particularly in those with underlying conditions or advanced age.