550. Rhinovirus Species in Severe Acute Respiratory Illness
Session: Poster Abstract Session: Respiratory Viruses
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • Diapositiva1.png (384.8 kB)
  • Background:

    Human Rhinoviruses (HRV) are frequent pathogens among children, mostly associated with common cold. Recently they have been classified in three different species (HRVA, HRVB and HRVC); it has been suggested that HRVC could be associated with more severe disease.

    Methods:

    The ILI002 Study was an observational study performed by La Red between 2010-2014, in order to describe the epidemiology, etiology and clinical characteristics of subjects with influenza-like illness (ILI) in Mexico. Six hospitals participated. Nasopharyngeal swabs were obtained at enrollment and tested by a multiplex PCR for 19 respiratory pathogens. We report the data of subject with the most severe ILI presentation (defined as intensive care unit (ICU) needed) in which HRV was detected. Fifty-two samples were sequenced in order to determine the HRV species.

    Results:

    There were 5240 patients enrolled in the study, with 1,089 detection with rhinovirs as a single pathogen. Of those, 101 required ICU care. HRV species was defined in 52 of them (7 adults and 45 children). Of seven adults (> 18 yo), 4 had HRVA and 3 HRVC (43%); in children (n=45), 44% were HRVC, 38% were HRVA, and only 7% were HRVB. In the phylogenetical analysis, there are 4 groups for HRVA and 5 groups for HRVC; HRVC is more divergent as a specie. In addition, one previously healthy child who was admitted in September 2011 was found to have an enterovirus D68 infection. No neurological complications were reported in this child. No deaths were present in this group of patients with HRV infection. No differences were found among demographic and clinical characteristics between patients with infections caused by different HRV species.

    Conclusion:

    In most of the published data HRVA is considered as a low pathogenic agent. We found almost the same proportion of severe cases with HRVA than with HRVC, suggesting that the severity of the disease caused by this species in children and adults may be underestimated. As an additional finding, we also document an ED68 severe case of ILI requiring ICU care, without neurological manifestations.

    Figure 1. HRV A Dendogram.

    Figure 2. HRV C Dendogram.

    Jesús Arturo Ruiz-Quiñones, MD1, Arturo Galindo-Fraga, MD, MS2, Pilar Ramos, MSc3, Fernando Ledesma, BS3, Sarbelio Moreno, MD4, Ana a Ortiz-Hernández, MD5, Alejandra Ramirez-Venegas, MD6, Rafael Valdez, MD7, Daniel Noyola, MD8, Ma. De Lourdes Guerrero Almeida, MD, MSc9, John Beigel, MD10, Guillermo Ruiz-Palacios, MD, FIDSA11,12,13 and Beatriz Llamosas-Gallardo, MD14, (1)Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, (2)Hospital Epidemiology and Medical Care Quality Control, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, (3)Molecular Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico, (4)Infectious Diseases, Hospital Infantil de Mexico Federico Gomez, Mexico city, Mexico, (5)Pediatrician, Instituto Nacional de Pediatria, Mexico city, Mexico, (6)Pulmonologist, Instituto Nacional de Enfermedades Respiratorias, Mexico, Mexico, (7)Infectology, Hospital Manuel Gea Gonzalez, Mexico City, Mexico, (8)Facultad de Medicina, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico, (9)Infectious Diseases, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico, (10)Leidos Biomedical Research, Inc. In support of clinical research section NIAD, National Institutes of Health, Bethesda, MD, (11)LaRed Network, Mexico City, Mexico, (12)Comisión Coordinadora de Institutos Nacionales de Salud y Hospitales de Alta Especialidad, Mexico, Mexico, (13)Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico city, Mexico, (14)Instituto Nacional de Pediatría, Mexico, Mexico

    Disclosures:

    J. A. Ruiz-Quiñones, None

    A. Galindo-Fraga, None

    P. Ramos, None

    F. Ledesma, None

    S. Moreno, None

    A. A. Ortiz-Hernández, None

    A. Ramirez-Venegas, None

    R. Valdez, None

    D. Noyola, None

    M. D. L. Guerrero Almeida, None

    J. Beigel, None

    G. Ruiz-Palacios, None

    B. Llamosas-Gallardo, None

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