Human rhinovirus infections in rural Thailand: epidemiological evidence for rhinovirus as both pathogen and bystander

PLoS One. 2011 Mar 29;6(3):e17780. doi: 10.1371/journal.pone.0017780.

Abstract

Background: We describe human rhinovirus (HRV) detections in SaKaeo province, Thailand.

Methods: From September 1, 2003-August 31, 2005, we tested hospitalized patients with acute lower respiratory illness and outpatient controls without fever or respiratory symptoms for HRVs with polymerase chain reaction and molecularly-typed select HRVs. We compared HRV detection among hospitalized patients and controls and estimated enrollment adjusted incidence.

Results: HRVs were detected in 315 (16%) of 1919 hospitalized patients and 27 (9.6%) of 280 controls. Children had the highest frequency of HRV detections (hospitalized: <1 year: 29%, 1-4 year: 29%, ≥ 65 years: 9%; controls: <1 year: 24%, 1-4 year: 14%, ≥ 65 years: 2.8%). Enrollment adjusted hospitalized HRV detection rates were highest among persons aged <1 year (1038/100,000 persons/year), 1-4 years (457), and ≥ 65 years (71). All three HRV species were identified, HRV-A was the most common species in most age groups including children aged <1 year (61%) and all adult age groups. HRV-C was the most common species in the 1-4 year (51%) and 5-19 year age groups (54%). Compared to controls, hospitalized adults (≥ 19 years) and children were more likely to have HRV detections (odds ratio [OR]: 4.8, 95% confidence interval [CI]: 1.5, 15.8; OR: 2.0, CI: 1.2, 3.3, respectively) and hospitalized children were more likely to have HRV-A (OR 1.7, CI: 0.8, 3.5) or HVR-C (OR 2.7, CI: 1.2, 5.9) detection.

Conclusions: HRV rates were high among hospitalized children and the elderly but asymptomatic children also had substantial HRV detection. HRV (all species), and HRV-A and HRV-C detections were epidemiologically-associated with hospitalized illness. Treatment or prevention modalities effective against HRV could reduce hospitalizations due to HRV in Thailand.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Child
  • Child, Preschool
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Influenza, Human / complications
  • Influenza, Human / virology
  • Middle Aged
  • Picornaviridae Infections / complications
  • Picornaviridae Infections / epidemiology*
  • Picornaviridae Infections / virology*
  • Rhinovirus / isolation & purification
  • Rhinovirus / physiology*
  • Rural Population / statistics & numerical data*
  • Seasons
  • Thailand / epidemiology
  • Young Adult