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Rhinoviruses are associated with numerous hospitalizations of children under the age of 5 years, especially those with asthma

Rhinoviruses are the usual cause of the common cold. However, a new study suggests that rhinoviruses are also an important cause of childhood hospitalizations for acute respiratory infection (ARI), especially among children with a history of asthma or wheezing. For example, 26 percent of children hospitalized in two States for respiratory symptoms or fever in 2000 and 2001 tested positive for rhinovirus infections. This represented nearly 5 rhinovirus-associated hospitalizations per 1,000 children. Age-specific rates per 1,000 children were 17.6 for infants up to 5 months old, 6.0 for 6- to 23-month-olds, and 2.0 for 24- to 59-month-olds.

Children with a history of wheezing or asthma were 8 times more likely to be hospitalized for rhinovirus-associated respiratory infections than those without such a history (25.3 vs. 3.1 per 1,000 children).

Historically, respiratory syncytial virus (RSV) has been regarded as the predominant virus associated with hospitalizations for acute respiratory infection in young children. Yet, this study detected more rhinoviruses (26 percent) than RSV (20 percent) among children under 5 years of age hospitalized with ARI or fever. Although rhinovirus was detected year-round in this 1-year study, 40 percent of all cases occurred in the spring.

The seasonal trend for asthma hospitalizations mirrored the seasonal trend for rhinovirus, with the exception of an additional peak during the winter, when RSV and influenza virus circulated. Nearly half (45 percent) of children hospitalized with ARI or fever lived in homes with smokers. Although most children with rhinovirus infections were hospitalized for less than 3 days, many required supplemental oxygen and a few required mechanical ventilation.

The findings were based on a study of 592 children under 5 years of age who were hospitalized with respiratory symptoms or fever at 2 sites in 2000 and 2001. The researchers analyzed responses to questionnaires, laboratory cultures, and medical charts. The study was supported in part by the Agency for Healthcare Research and quality (T32 HS13833).

See "Rhinovirus-associated hospitalizations in young children," by E. Kathryn Miller, M.D., M.P.H., Xiaoyan Lu, Dean D. Erdman, and others, in the March 15, 2007, Journal of Infectious Diseases 195, pp. 773-781.

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