rhino virus an update

7/28/2019 Rhino virus an update

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Rhinovirusan updateDr.T.V.Rao MD

Dr.T.V.Rao MD 1


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Common cold Pharyng Tracheobronchitis Pneumonia

RHINOVIRUSES

INFLUENZA type A

INFLUENZA type BCORONAVIRUSES

ADENOVIRUSES (types 1-5,7)

EPSTEIN-BARR VIRUS

RSV

PARAINFLUENZA (types 1-3)

COXSACKIE (group A & B)

ECHOVIRUS

+++

++

-

+

+

+

+

++

+

-

+

+

-

-

Viral Organisms in U.R.I.

Adults

Dr.T.V.Rao MD 2


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Coryza Pharyngitis Croup Tr.bronchitis PneumoniaRSV

PARAINFLUENZA (type 3)

PARAINFLUENZA (type 2)

PARAINFLUENZA (type 1)RHINOVIRUSES

INFLUENZA type A

INFLUENZA type B

ADENOVIRUSES (types 1-3,5)CORONAVIRUSES

EPSTEIN-BARR VIRUS

COXSACKIE (group A & B)

ECHOVIRUS

++

++

++

++++

+++

-

+

+

+

++

+

+

+

+

+

+

+

+++

+

-

++

++

-

+

+

+

-

+++

++

++

+

-

Viral Organisms in U.R.I.

Children

Dr.T.V.Rao MD 3


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Rhinoviruses Rhinoviruses (from the Greek (gen.) "nose")

are the most common viral infective agents inhumans and are the predominant cause of the

common cold. Rhinovirus infectionproliferates in temperatures between 3335C (9195 F), and this may be why it occursprimarily in the nose. Rhinovirus is a species in

the genus Enterovirus of the Picornaviridaefamily of viruses.

Dr.T.V.Rao MD 4


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Viral Rhinitis

sites infected

Rhinovirus nose > pharynx > saliva

90% 70% 50%

Coronavirus ?nose

Parainfluenza, RSV, adenovirus U & L.RT

Influenza extensive destruction of U & L.RT(ciliated, intermediate and basal

cells of epithelium)

Ebisava et al, 1969)Dr.T.V.Rao MD 5


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Rhinoviruses are the most commonly

isolated viruses from persons with mild

upper respiratory illness.

Rhinoviruses are a genus of picornaviridae In contrast to enteroviruses they do not

replicate in the intestinal tract, they have an

extreme species specificity and morefastidious growth requirements

Rhinoviruses are ..

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RHINOVIRUS GROUP

Produces Common Cold.

Mild respiratory Illness.

More than 100 serotypes

Nasal secretions are infective.

Mistaken with Infections with

Corona viruses,

Adenovirus.

Para influenza viruses.

Influenza virusesDr.T.V.Rao MD 7


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Properties of Rhinoviruses.

Gross appearance like Entero viruses,

Acid Labile destroyed at 3.0 pH.

Grown inHuman Cell lines,

WI 38

MRC -5

Cultivated at 330 c

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Rhinovirus

Picornoviridae family

Size

Single stranded

Incubation period of 1to 3 days

Optimum growth occursbetween 33 and 34 deg

Celsius (93 deg F) Not stable below the pH

of 5-6

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Rhino Virus

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Structure

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Entering a Cell

Dr.T.V.Rao MD 12

Rhinovirus bonded to a CAM

1 receptor

Antibodies bonded to a

rhinovirus


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Understanding Common cold

leading cause of doctor visits and lost hours

both at school and the workplace over >100different viruses found to cause symptoms

of the common cold responsible for about70% of the cases where a virus has beenfound one of the most common illnesses toman 35 to 50% of the total number of

common colds

Hand to hand contact

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Transmission of Rhinoviruses

There are two

modes of

transmission: via

aerosols of

respiratory droplets

and from

contaminatedsurfaces, including

direct person-to-

person contact. Dr.T.V.Rao MD 14


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Pathogenesis - Rhinoviruses

Entry through Respiratory tract. Nasal Mucosa, can infect Lower Respiratory

tract.

Chilling, wearing wet cloths do not produceinfection.

But common cold starts with chills.

Local inflammation and cytokines may beresponsible for the symptoms of common

cold.

Interferon production occurs early and specificantibod a ears in nasal secretionsDr.T.V.Rao MD 15


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PathogenesisEpithelial destruction hypothesis:

intact nasal epithelium (Winther et al)

rhinovirus replication in extremely

small number of cells (Arrunda et al)

viral quantity does not influence

duration nor severity of colds (Arrunda

et al) Dr.T.V.Rao MD 16


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Pathogenesis

Inflammatory

cascade

hypothesis:Common cold

symptoms result

from an

inflammatory

cascade triggered

by a viral infectionDr.T.V.Rao MD 17


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Cytokines initiate pathogenic process

Small number of virusinfected cells elaborate a

variety of cytokines

initiating a host

inflammatory response,which orchestrate

chemotaxis and expression

of endothelial adhesion

receptor molecules resultingin the typical common cold

symptoms.

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Interleukin-1 T-cell activation

B-cell profileration, antibody synthesis

up-regulation adhesion molecule expression

mediator, cytokine, growth factor induction

increased vascular permeabilitiy

up-regulation kinin receptor expression

hematopoietic progenitor cell stimulation

neuro-endocrine interactionsDr.T.V.Rao MD 19


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Clinical Findings.

Incubation 2-4 days,

Last for 7 days.

Sneezing, NasalObstruction, Sore

throat,

May lead to

secondary infection

with Bacteria.

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The common cold, nasal congestion iscaused by a vasodilation of the subepithelial

capillaries and of the cavernous sinuses, by

edema in the lamina propria and by

inflammatory processes in which neutrophils

and kinins play an important role.

o Histamine plays only a minor role in the

symptoms of common cold

o Little is known about the role of

prostaglandins and leukotrienes in the

common cold. Dr.T.V.Rao MD 21


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Clinical Findings.

Incubation 2-4 days,

Last for 7 days.

Sneezing, NasalObstruction, Sore

throat,

May lead to

secondary infection

with Bacteria.

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Laboratory Diagnosis

Isolation of virus

may be obtained

from nasal orthroat swabs

collected early in

infection. Culturing on MRC5

or W 138

Appearing of CPE Dr.T.V.Rao MD 23


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Immunity Rhinoviruses.

Antibodies in

Nose

Recurrentinfections with

antigenic

variants, may be

2-3 attacks a year.

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Prevention and Control

No specific

treatment.

Vaccines areunsuccessful.

Intranasal spray ofGamma

Interferon for 5

DaysDr.T.V.Rao MD 25


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Epidemiology - Rhinoviruses.

Prevalent all over the

world.

Close Contact.

Fingers and Hand- Hand washing.

High rate ofinfection in Infantsand Children.

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CDC Recommends

The CDC recommends

that children with

symptoms lasting more

than 10 days who areunresponsive to over-

the-counter

medications or with

fevers over 100.4degrees Fahrenheit

seek medical attention.

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Dr.T.V.Rao MD 28


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Stop Spreading the Virus

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Use Tissue Paper Use paper

:Instead of shared

cloth towels.

Individuals with

colds should

always sneeze or

cough into a facial

tissue, and

promptly throw it

awa .Dr.T.V.Rao MD 30


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Hand washing

Hand washing is thesimplest and mosteffective way to keepfrom getting rhinovirus

colds. Children andadults should washhands at key momentsafter nose-wiping, after

diapering or toileting,before eating, andbefore preparing food.

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Treatments are Still Experimental

DRACO, a broad-spectrum

antiretroviral therapy being

developed at the MassachusettsInstitute of Technology, has shown

preliminary effectiveness in treating

rhinovirus, as well as a number ofother infectious viruses

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Preventing Common Cold

There is no vaccine to protect you against

the common cold. However, you may be

able to reduce your risk of getting a cold

by taking these steps:

wash your hands often with soap and

water do not touch your eyes, nose, ormouth with unwashed hands stay away

from people who are sick

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Prospects of Vaccine

There are no vaccines against these viruses asthere is little-to-no cross-protection betweenserotypes. At least 99 serotypes of Human

rhinoviruses affecting humans have beensequenced. However, recent study of the VP4protein has shown it to be highly conservedamongst many serotypes of Human

rhinovirus, opening up the potential for afuture pan-serotype Human rhinovirusvaccine.

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The Programme Created by

Dr.T.V.Rao MD for Medical and

Health care Workers in theDeveloping World

Email

[email protected]

Dr TVRao MD 35

rhino virus an update

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