MRCEM Notes

Rhinovirus

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Background

Rhinoviruses are the most common cause of the common cold and belong to the Picornaviridae family. They are transmitted via respiratory droplets and direct contact, with peak incidence in autumn and spring. Due to their ability to survive on surfaces, fomite transmission can occur.

Rhinovirus causes the common cold. There are over 100 serotypes hence immunity does not typically occur following infection.

Clinical features

Rhinovirus infection typically presents as an upper respiratory tract infection (URTI) with symptoms including:
  • Nasal congestion and rhinorrhoea
  • Sore throat
  • Sneezing
  • Mild cough
  • Low-grade fever (less common)
  • Headache and malaise

Incubation is relatively short at 1-4 days and viral transmission is highest during the symptomatic phase.

Symptoms typically last 5–10 days, with peak severity around days 2–3. Viral shedding begins before symptom onset, peaks within the first few days of illness, and continues for several days leading to high transmissibility.

Diagnosis

Diagnosis of rhinovirus infection is clinical, based on the characteristic symptoms of a self-limiting URTI. Routine laboratory testing is not required, but PCR or viral culture can confirm the virus in research or outbreak settings.

Immunity and Reinfection

Immunity to rhinovirus is short-lived and incomplete, primarily due to the vast number of serotypes (over 160 identified). This antigenic diversity prevents long-term immunity, making recurrent infections common throughout life.
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