What is the duration of contagiousness with enterovirus (EV)/rhinovirus (RV) upper respiratory tract infection (URTI)?

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From the Guidelines

Individuals with enterovirus or rhinovirus upper respiratory tract infections are most infectious soon after they develop symptoms, and although they continue to excrete virus for up to five days after the onset of symptoms, the amount of virus, and hence the infection risk, drops steadily. When considering the duration of contagiousness with enterovirus (EV)/rhinovirus (RV) upper respiratory tract infection (URTI), it's essential to understand the modes of transmission and the period during which an individual is most likely to spread the infection. According to the study by 1, the incubation period for such infections is typically 48 to 72 hours, with a range from 24 hours to 7 days. Key points to consider include:

  • The contagious period generally begins shortly before symptoms appear, as spread from a person before they develop symptoms has been recorded, albeit rarely 1.
  • Infected individuals are most infectious soon after they develop symptoms, with the infection risk dropping steadily over time 1.
  • Children tend to remain contagious longer than adults, with viral shedding persisting for up to 7 days in children compared to up to 5 days in adults 1.
  • To reduce transmission, practicing good hand hygiene, avoiding touching one's face, covering coughs and sneezes, disinfecting frequently touched surfaces, and staying home while symptomatic are recommended.
  • These viruses spread through respiratory droplets and contact with contaminated surfaces, with the virus entering through the eyes, nose, or mouth 1. The duration of contagiousness can vary due to factors such as individual immune response, viral strain, and age, with immunocompromised individuals potentially remaining contagious for extended periods. However, based on the most recent and highest quality evidence available, the primary concern for contagion is during the initial 5 days after symptom onset.

From the Research

Duration of Contagiousness with Enterovirus (EV)/Rhinovirus (RV) Upper Respiratory Tract Infection (URTI)

  • The duration of contagiousness with EV/RV URTI is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
  • However, it is known that most URTIs are short, mild, and self-limiting, but some can lead to serious complications 2.
  • The effectiveness of management strategies for acute URTI is highly increased with early intervention, administered prior to the peaking of viral shedding 2.
  • EV-HRV infection can cause upper respiratory tract infections, but can also cause cytokine releases in the lower respiratory tract and in the blood, which can lead to acute respiratory distress syndrome (ARDS) 3.
  • The nonpoliovirus enteroviruses can infect newborns, with consequences ranging from asymptomatic infection and benign illness, to severe, life-threatening disease 4.
  • Rhinoviruses and/or enteroviruses were detected in 29.6% of pediatric patients with acute respiratory illness, and were the most frequently detected viruses in both prepandemic and pandemic periods 5.
  • A multiplex nested PCR procedure was developed to detect and differentiate rhinoviruses and enteroviruses in upper respiratory tract samples 6.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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