Rhinovirus infection is an acute viral lesion of the upper respiratory tract – the nose and nasopharynx. The course is characterized by general infectious symptoms (subfebrility, cognition, malaise), sore throat, sneezing, stuffiness and copious discharge from the nose, aching in the bridge of the nose, lack of sense of smell. The diagnosis is usually established according to clinical data; serological and virological studies are possible. With rhinovirus infection, instillations of vasoconstrictive drops and interferon into the nose, hot foot baths, taking immunocorrectors, anti-inflammatory, antihistamines are indicated.
General information
Rhinovirus infection is a type of acute respiratory infection caused by rhinoviruses and occurring in the form of rhinitis and pharyngitis. Rhinovirus infection accounts for 25% to 40% of all viral colds. The incidence among various age groups is registered year-round, but the epidemic rise is usually noted in September and April. Rhinovirus infection is more typical for countries with temperate and cold climates. During the year, a person can get over rhinovirus infection repeatedly. Infection can provoke the development of chronic bronchitis and bronchial asthma in children and adults, therefore it is relevant not only for infectious diseases, but also for pulmonology and pediatrics.
Causes
The etiological agents causing rhinovirus infection are viruses of the picornavirus family. There are 113 serological types of rhinoviruses. Viral particles of pathogens contain RNA; their diameter is 20-30 nm. The optimal temperature for the growth of rhinoviruses is 33-34 ° C (this is the temperature maintained in the nasal passages of a person). At the same time, the absence of an outer shell makes rhinoviruses poorly resistant to temperature changes, drying, and exposure to disinfectants.
Reservoirs and distributors of rhinovirus infection are carriers of the pathogen or sick people who are contagious a day before the onset of symptoms and for the next 5-9 days. Infection of others occurs mainly by airborne droplets. Contact-household transmission of rhinovirus infection through hands and household items contaminated with nasal secretions of the patient is not excluded, but in practice it is extremely rare due to the instability of rhinovirus in the external environment.
Susceptibility to rhinovirus infection is high; outbreaks occur more often in small groups (family, kindergarten group, school class, etc.). The risk of morbidity largely depends on the premorbid background, the state of immunity, the duration of contact with the patient or the virus carrier. Rhinovirus enters the body through the mucous membrane of the nasal passages, where it multiplies in epithelial cells. This is due to the development of a local focus of inflammation with pronounced swelling, swelling and hypersecretion of the nasal mucosa, which reach their maximum severity on 2-4 days after infection. Activation of local and general immune protection leads to the appearance of specific IgA in the nasal secretions of patients, and IgG in the blood. This explains that rhinovirus infection usually occurs in the form of rhinitis and rhinopharyngitis. With the weakening of protective factors, the development of viremia with the appearance of infectious and toxic symptoms is possible.
Symptoms
Clinical symptoms develop after a short incubation period (from 1 to 5 days). On the first day of the manifest stage, nasal congestion appears, abundant serous-mucous discharge from the nasal passages, temperature rise no higher than 38 ° C, cognition, general malaise. Intoxication syndrome is expressed weakly or moderately; catarrhal manifestations (violation of nasal breathing, runny nose, sneezing, a feeling of tickling in the throat, coughing) cause greater concern to patients. Due to the abundant discharge of nasal secretions and frequent use of a handkerchief, there is hyperemia, peeling and maceration of the skin around the nasal passages, sometimes herpes appears on the lips and on the threshold of the nose. There is an injection of conjunctiva and sclera, lacrimation, hyperemia of the eyelids.
Usually, a rhinovirus infection lasts 5-7 days and ends with a complete recovery without consequences. In a complicated scenario of rhinovirus infection, soreness in the bridge of the nose, lack of taste and smell, ear pain and hearing loss are possible. The layering of microbial infection is fraught with the development of sinusitis, otitis media, laryngitis, tracheobronchitis, pneumonia. In addition, rhinoviruses can cause exacerbation of bronchial asthma and COPD.
Diagnosis and treatment
Usually, rhinovirus infection is diagnosed solely by clinical signs (abundant mucous rhinorrhea, maceration of the skin on the threshold of the nose, mild malaise, subfebrile or normal body temperature) and the epidemiological situation in the immediate environment. When examining the pharynx, hyperemia and swelling of the oropharyngeal mucosa, fine graininess of the soft palate are determined.
To clarify the etiological diagnosis, the virus can be isolated from nasal mucus or flushes from the nasal mucosa on tissue culture, however, due to the transience of rhinovirus infection, it is rarely resorted to in practice. The immunofluorescence reaction is used for express diagnostics and allows detecting rhinovirus antigens in the epithelial cells of the nasal conchs. Rhinovirus infection must be distinguished from influenza, parainfluenza, adenovirus, respiratory syncytial, coronavirus infection. Allergic rhinitis, streptococcal nasopharyngitis, a foreign body of the nose should also be excluded. With a complicated course of rhinovirus infection, consultation with an otolaryngologist or a pulmonologist may be required.
The course of rhinovirus infection is usually benign; in most cases, the disease is stopped independently without specific treatment. With rhinovirus infection, symptomatic therapy is recommended mainly: copious warm drinking, instillation of vasoconstrictors and interferon into the nasal passages, nasal rinsing with saline solutions, taking anti-inflammatory and antihistamines, hot foot baths. The development of a vaccine against rhinovirus infection is difficult due to the large number of rhinovirus serotypes. General antiepidemic measures are similar to those for other acute respiratory infections (isolation of patients, frequent ventilation and wet cleaning of premises with disinfectants, quartz treatment, preventive use of immunocorrectors).
