Human rhinovirus species and season of infection determine illness severity

Wai Ming Lee, Robert F. Lemanske, Michael D. Evans, Fue Vang, Tressa Pappas, Ronald Gangnon, Daniel J. Jackson, James E. Gern

Research output: Contribution to journalArticlepeer-review

247 Scopus citations


Rationale: Human rhinoviruses (HRVs) consist of approximately 160 types that cause a wide range of clinical outcomes, including asymptomatic infections, common colds, and severe lower respiratory illnesses. Objectives: To identify factors that influence the severity of HRV illnesses. Methods: HRV species and types were determined in 1,445 nasal lavages thatwere prospectively collectedfrom209 infants participating in a birth cohort who had at least one HRV infection. Questionnaires were used during each illness to identifymoderate to severe illnesses (MSI). Measurements and Main Results: Altogether, 670 HRV infections were identified, and 519 of them were solitary infections (only one HRV type). These 519 viruses belonged to 93 different types of three species: 49 A, 9 B, and 35 C types. HRV-A (odds ratio, 8.2) and HRV-C(odds ratio, 7.6) were more likely to cause MSI compared with HRV-B. In addition, HRV infections were 5- to 10-fold more likely to cause MSI in the winter months (P , 0.0001) compared with summer, in contrast to peak seasonal prevalence in spring and fall.When significant differences in host susceptibility to MSI (P = 0.004) were considered, strain-specific rates of HRV MSI ranged from less than 1% to more than 20%. Conclusions: Factors related to HRV species and type, season, and host susceptibility determine the risk of more severe HRV illness in infancy. These findings suggest that anti-HRV strategies should focus on HRV-A and -C species and identify the need for additional studies to determine mechanisms for seasonal increases of HRV severity, independent of viral prevalence, in cold weather months.

Original languageEnglish (US)
Pages (from-to)886-891
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Issue number9
StatePublished - Nov 1 2012
Externally publishedYes


  • Rhinovirus
  • Seasonality
  • Severe illness
  • Species
  • Type


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