Title Human rhinovirus C associated with wheezing in hospitalised children in the Middle East.
Author Miller, E Kathryn; Khuri-Bulos, Najwa; Williams, John V; Shehabi, Asem A; Faouri, Samir; Al Jundi, Ihsan; Chen, Qingxia; Heil, Luke; Mohamed, Yassir; Morin, Laura-Lee; Ali, Asad; Halasa, Natasha B
Journal J Clin Virol Publication Year/Month 2009-Sep
PMID 19581125 PMCID PMC2759319
Affiliation 1.Department of Pediatrics, Vanderbilt University, Nashville, TN, USA. eva.k.miller@vanderbilt.edu.

BACKGROUND: Few studies have investigated the disease burden and genetic diversity of human rhinoviruses (HRVs) in developing countries. OBJECTIVES: To assess the burden of HRV in Amman, Jordan, and to characterise clinical differences between HRV groups. STUDY DESIGN: We prospectively studied children <5 years, hospitalised with respiratory symptoms and/or fever in Amman, Jordan. Viruses were identified by real-time reverse transcriptase polymerase chain reaction (RT-PCR). VP4/VP2 gene sequencing was performed on HRV-positive specimens. RESULTS: Of the 728 enrolled children, 266 (37%) tested positive for picornaviruses, 240 of which were HRV. Of the HRV-positive samples, 62 (26%) were of the recently identified group HRVC, 131 (55%) were HRVA and seven (3%) were HRVB. The HRVC strains clustered into at least 19 distinct genotypes. Compared with HRVA-infected children, children with HRVC were more likely to require supplemental oxygen (63% vs. 42%, p=0.007) and, when co-infections were excluded, were more likely to have wheezing (100% vs. 82%, p=0.016). CONCLUSIONS: There is a significant burden of HRV-associated hospitalisations in young children in Jordan. Infection with the recently identified group HRVC is associated with wheezing and more severe illness.

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