From the Guidelines
A positive swab for human rhinovirus/enterovirus indicates you have a viral infection that commonly causes the common cold or mild respiratory illness, and treatment is primarily supportive care since antibiotics don't work against viruses. The management of this condition should focus on alleviating symptoms and preventing complications, as outlined in the guidelines for enterovirus diagnostics and characterization 1.
Key Considerations
- The infection can cause a range of symptoms from mild to severe, including fever, respiratory issues, and in rare cases, neurological complications 1.
- Treatment is mainly supportive, aiming to reduce fever and discomfort with medications like acetaminophen (Tylenol) 650mg every 6 hours or ibuprofen (Advil, Motrin) 400mg every 6-8 hours as needed 1.
- Rest, hydration, and the use of saline nasal sprays or humidifiers can help ease congestion and improve symptoms 1.
- It's crucial to practice good hygiene, such as frequent hand washing, covering coughs and sneezes, and considering staying home to avoid infecting others, as these viruses spread easily through respiratory droplets 1.
When to Seek Medical Attention
- Difficulty breathing
- Persistent high fever
- Severe headache
- Symptoms worsening after initial improvement
- Underlying conditions like asthma or compromised immune systems, which may increase the risk of complications 1.
Diagnostic Approach
The diagnosis and characterization of enterovirus infections involve various clinical specimens, including nasopharyngeal swabs, stool, CSF, and blood, with the choice of specimen depending on the clinical manifestations and the timing of sample collection 1. Sequencing part of the VP1 capsid protein gene is the gold standard for EV typing, as recommended by the WHO 1, and is essential for identifying the specific type of enterovirus and for epidemiological monitoring.
Given the potential for severe outcomes, especially in young children and individuals with underlying health conditions, close monitoring and prompt medical evaluation are recommended if symptoms persist or worsen 1.
From the Research
Human Rhinovirus/Enterovirus Infection
- Human rhinoviruses (HRV) are non-enveloped, single-stranded RNA viruses that cause acute diseases of the upper respiratory tract, as well as lower respiratory tract illnesses such as bronchiolitis and pneumonia 2.
- HRV infections are commonly identified in children with acute respiratory infections (ARIs), and can be severe, especially in those with underlying immunosuppressive conditions 3.
- A study found that children with single HRV/enterovirus (ENT) infections had increased odds of hospitalization and severe clinical disease compared to those with respiratory syncytial virus (RSV) or influenza A/B (FLU) infections 3.
- HRV/ENT infections can also cause severe respiratory illness in adults, including acute respiratory distress syndrome (ARDS) 4.
Treatment and Prevention
- There is currently no approved antiviral therapy for HRV infections, and treatment remains primarily supportive 2, 5.
- Antiviral therapeutic approaches, including small molecule inhibitors and antiviral host defense peptides, are being researched as potential novel therapeutics for HRV infections 6.
- Strict adherence to hygiene measures can reduce the risk of acquiring an HRV infection 2.
- An effective vaccine for HRV is not yet available, due to the large variety of rhinovirus serotypes 2, 6.
Clinical Severity
- HRV/ENT infections can present with severe clinical manifestations, including hospitalization, intensive care admission, and oxygen requirements 3.
- Children with HRV/ENT infections often have significant comorbidities, such as underlying immunosuppressive conditions 3.
- Adults with HRV/ENT infections can also experience severe respiratory illness, including ARDS and prolonged respiratory failure 4.