Program Schedule

1137
Epidemiology and Persistence of Human Rhinovirus Infections in Childcare

Session: Poster Abstract Session: Viral Infections: Epidemiology
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • Clinical HRV_IDWeek_FINAL.pdf (2.2 MB)
  • Background: Human rhinoviruses (HRV) are the most common cause of respiratory illness in adults and children.  Use of molecular technology has allowed for enhanced detection of HRV and differentiation between infections with different HRV genotypes.  We aimed to describe HRV shedding patterns in symptomatic and asymptomatic children attending childcare.

    Methods: Children ages 5 weeks to 30 months were prospectively enrolled from three large childcare centers located in Fort Lewis, WA, USA.  Nasopharyngeal swabs were collected at enrollment and at onset and weekly during respiratory illness episodes until symptoms resolved. Nasal samples were tested by PCR for HRV and other respiratory viruses and HRV genotype was determined by sequencing the 5’ non-coding region. Extended shedding was defined as consecutive positive swabs at least 7 days apart.

    Results: During the study period, 225 children were enrolled. A total of 127 children provided an asymptomatic nasal swab at enrollment, with 52 (41%) having HRV present.  HRV was detected during 223 out of 455 prospectively-captured illnesses; 123 children had HRV detected during at least one illness.  HRV detection persisted for at least 7 days in 28% of all HRV illnesses (n=62; mean duration 16 days among those with extended shedding). Only 5 of 62 illnesses with extended shedding (8%) had multiple HRV genotype groups identified in different swabs. Respiratory illness symptoms, including fever and cough, were similar regardless of the duration of shedding. HRV illnesses accompanied by other coinfecting respiratory viruses were more likely to have extended shedding compared to illnesses with HRV alone (mean 7 versus 1 days, respectively; p<0.001).   Children under 9 months of age shed for a mean of 4 days longer than older children (p=0.03). 

    Conclusion: We found that extended shedding occurred in over a third of all incident HRV infections. Risk factors for HRV extended shedding include young age and respiratory viral coinfections. In most cases, shedding was not due to subsequent infection with multiple HRV genotypes. This extended shedding may provide an explanation, especially in young children, for the high rates of asymptomatic detection of rhinovirus that has been previously reported.

    Emily T. Martin, MPH, PhD1, Hillary Jones1, Emily Martin, BS2, Helen Y. Chu, MD MPH3, Mary Fairchok, MD4, Jane Kuypers, PhD5 and Janet a. Englund, MD, FIDSA2, (1)Pharmacy Practice, Wayne State University, Detroit, MI, (2)Seattle Children's Hospital, Seattle, WA, (3)Allergy & Infectious Diseases, University of Washington, Seattle, WA, (4)Infectious Disease Clinical Research Program, Tacoma, WA, (5)University of Washington, Seattle, WA

    Disclosures:

    E. T. Martin, None

    H. Jones, None

    E. Martin, None

    H. Y. Chu, None

    M. Fairchok, None

    J. Kuypers, None

    J. A. Englund, Gilead: Consultant and Investigator, Consulting fee and Research support
    Chimerix: Investigator, Research support
    Roche: Investigator, Research support
    GlaxoSmithKline: Consultant, Investigator and Member, DSMB (DataSafety Monitoring Board), Consulting fee, Payment for DSMB participation and Research support
    Ansun Biopharma: Investigator, Research support
    MedImmune: Grant Investigator, Research support
    Seattle Children's Hospital: Investigator, Research support

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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