Severe Human Rhinovirus Outbreak Associated With Fatalities in a Long‐term Care Facility in Ontario, Canada

Longtin, Jean; Winter, Anne-Luise; Heng, Denis; Marchand-Austin, Alex; Eshaghi, Alireza; Patel, Samir N.; Weir, Erica; Low, Donald E.; Gubbay, Jonathan B.

doi:10.1111/j.1532-5415.2010.03091.x

Cited by 16 publications

(16 citation statements)

References 9 publications

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“…10 Subsequent versions of this assay would benefit from improved HRV sensitivity given reports of HRV causing clinically significant disease. 11,12 …”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of two highly multiplexed respiratory virus assays in a pediatric cohort

Forman

Advani

Newman

et al. 2012

Journal of Clinical Virology

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Background Rapid detection of respiratory viruses is important for management and infection control in hospitalized patients. Multiplex nucleic acid tests (NATs) have begun to replace conventional methods as gold standards for respiratory virus detection. Objective To compare the performance of two large multiplex NATS, ResPlex II (RPII) and Respiratory Virus Surveillance kit with electrospray ionization mass spectrometry (RVS/MS) using nasopharyngeal aspirates (NPAs) from hospitalized children who had been tested previously with conventional methods. Study design Stored residual NPAs (N = 306) were tested concomitantly by RPII and RVS/MS. Alternate NATs were used to adjudicate discordant results. Results More viruses were detected with multiplex NATs (RPII, 110; RVS/MS, 109) than conventional assays (86); diagnostic gain was primarily for fastidious viruses (coronaviruses and enteroviruses [EVs]/human rhinoviruses [HRVs]). Total positive and negative agreement between the multiplex NATs for all viruses detected was quite high (86% positive agreement, 99% negative agreement). Most individual viruses were detected with fairly equivalent accuracy by the multiplex NATs, except for adenoviruses (RPII sensitivity 40%) and human metapneumovirus (RVS/MS sensitivity 42%). RPII had the advantage of detecting EVs and HRVs, however, it demonstrated considerable EV/HRV cross-reactivity (29 HRV-positive specimens by real-time PCR were positive for EV by RPII and 21 specimens positive for HRV only by RT-PCR were dual positive for EV/HRV by RPII). RPII also had reduced sensitivity for HRV detection (in 36 specimens, HRV was detected by RT-PCR but not by RPII). Conclusions Both multiplex NATs were promising, but had notable limitations.

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“…10 Subsequent versions of this assay would benefit from improved HRV sensitivity given reports of HRV causing clinically significant disease. 11,12 …”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of two highly multiplexed respiratory virus assays in a pediatric cohort

Forman

Advani

Newman

et al. 2012

Journal of Clinical Virology

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“…125,126 Rhinovirus has been reported as a cause of ARDS most frequently in elderly and immunocompromised adults. 127 Autopsy findings of 4 bone marrow transplant patients with suspected HRV pneumonia showed findings consistent with viral pneumonia, including acute and chronic interstitial pneumonitis and diffuse alveolar damage with hyaline membrane consistent with ARDS. 128 Among patients with pneumonia admitted to an ICU at a single center in South Korea, 96.2% of patients with HRV pneumonia required mechanical ventilation, and 59.3% had diffuse abnormalities on CXR suggestive of ARDS.…”

Section: Rhinovirusmentioning

confidence: 97%

Viral Pneumonia and Acute Respiratory Distress Syndrome

Shah

Wunderink

2017

Clinics in Chest Medicine

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Respiratory viruses are a common cause of severe pneumonia and acute respiratory distress syndrome (ARDS) in adults. The advent of new diagnostic technologies, particularly multiplex reverse transcription polymerase chain reaction, have increased the recognition of viral respiratory infections in critically ill adults. Supportive care for adults with ARDS caused by respiratory viruses is similar to the care of patients with ARDS from other causes. Although antiviral therapy is available for some respiratory viral infections, further research is needed to determine which groups of patients would benefit.

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“…It is a leading cause of respiratory virus infections causing hospitalizations in children: some 25-50% of children with respiratory symptoms test positive for HRV (Legg et al, 2005;Van der Zalm et al, 2011). HRV exacerbate chronic respiratory diseases and increase morbidity rates in the elderly (Gerna et al, 2009;Jartti and Korppi, 2011;Longtin et al, 2010a). Viral infections cause 85% of asthma exacerbations in children, and HRV infections are responsible for 50-80% of these exacerbations (Kelly and Busse, 2008;Wark et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Use of an improved quantitative polymerase chain reaction assay to determine differences in human rhinovirus viral loads in different populations

Granados

Luinstra

Chong

et al. 2012

Diagnostic Microbiology and Infectious Disease

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Human rhinoviruses (HRV) frequently cause acute respiratory infections and chronic respiratory disease exacerbations. However, testing is not generally offered. We developed a modified HRV quantitative polymerase chain reaction (qPCR) assay to assess viral loads in the community and hospital patients. The assay had a lower limit of detection of 2 log(10) viral copies/mL and displayed linearity over 5 log(10) viral copies, with a lower limit of quantitation of 4 log(10) viral copies/mL. Mean viral loads (95% confidence interval) for hospitalized children, university students, and institutionalized elderly, were 7.08 log(10) viral copies/mL (6.7-7.5), 6.87 log(10) viral copies/mL (6.5-7.2), and 7.09 log(10) viral copies/mL (6.9-7.3), respectively (P = 0.67). Serial specimens of 14 university students showed a decrease of mean viral loads from 6.36 log(10) viral copies/mL on day 1 to 2.32 log(10) viral copies/mL 7 days past symptom onset (P < 0.001). Using an HRV qPCR, we showed that viral loads did not differ between the community and hospitalized populations and significantly decreased following symptoms onset in healthy individuals.

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Severe Human Rhinovirus Outbreak Associated With Fatalities in a Long‐term Care Facility in Ontario, Canada

Cited by 16 publications

References 9 publications

Diagnostic performance of two highly multiplexed respiratory virus assays in a pediatric cohort

Diagnostic performance of two highly multiplexed respiratory virus assays in a pediatric cohort

Viral Pneumonia and Acute Respiratory Distress Syndrome

Use of an improved quantitative polymerase chain reaction assay to determine differences in human rhinovirus viral loads in different populations

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