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  1. 1. Rhinovirus <br />Dr.T.V.Rao MD<br />Dr.T.V.Rao MD<br />1<br />
  2. 2. Viral Organisms in U.R.I.<br />Adults<br />Dr.T.V.Rao MD<br />2<br />
  3. 3. Viral Organisms in U.R.I.<br />Children<br />Dr.T.V.Rao MD<br />3<br />
  4. 4. Viral Rhinitis<br /><ul><li>sites infected</li></ul> Rhinovirus nose > pharynx > saliva<br /> 90% 70% 50%<br /> Coronavirus ?nose<br /> Parainfluenza, RSV, adenovirus U & L.RT<br /> Influenza extensive destruction of U & L.RT (ciliated, intermediate and basal cells of epithelium)<br />Ebisava et al, 1969)<br />Dr.T.V.Rao MD<br />4<br />
  5. 5. HUMAN RHINOVIRUSES<br />Human rhinoviruses(from the Greek ῥίς, ῥινός (gen.) "nose") are the most common viral infective agents in humans and are the predominant cause of the common cold. Rhinovirus infection proliferates in temperatures between 33–35 °C (91–95 °F), and this may be why it occurs primarily in the nose. Rhinovirus is a species in the genus Enterovirus of the Picornaviridae family of viruses.<br />Dr.T.V.Rao MD<br />5<br />
  6. 6. <ul><li>Rhinoviruses are the most commonly isolated viruses from persons with mild upper respiratory illness.
  7. 7. Rhinoviruses are a genus of picornaviridae
  8. 8. In contrast to enteroviruses they do not replicate in the intestinal tract, they have an extreme species specificity and more fastidious growth requirements</li></ul>Rhinoviruses are ..<br />Dr.T.V.Rao MD<br />6<br />
  9. 9. RHINOVIRUS GROUP <br />Produces Common Cold.<br />Mild respiratory Illness.<br />More than 100 serotypes<br />Nasal secretions are infective.<br /> Mistaken with Infections with<br /> Corona viruses,<br /> Adenovirus.<br /> Para influenza viruses.<br /> Influenza viruses<br />Dr.T.V.Rao MD<br />7<br />
  10. 10. Properties of Rhinoviruses.<br />Gross appearance like Entero viruses,<br />Acid Labile destroyed at 3.0 pH.<br />Grown in <br /> Human Cell lines,<br /> WI – 38<br /> MRC -5<br />Cultivated at 330 c <br />Dr.T.V.Rao MD<br />8<br />
  11. 11. Rhinovirus<br />Picornoviridae family<br />Size<br />Single stranded<br />Incubation period of 1 to 3 days<br />Optimum growth occurs between 33 and 34 deg Celsius (93 deg F)<br />Not stable below the pH of 5-6<br />Dr.T.V.Rao MD<br />9<br />
  12. 12. Rhino Virus <br />Dr.T.V.Rao MD<br />10<br />
  13. 13. Structure<br />Dr.T.V.Rao MD<br />11<br />
  14. 14. Entering a Cell<br />Rhinovirus bonded to a CAM 1 receptor<br />Antibodies bonded to a rhinovirus<br />Dr.T.V.Rao MD<br />12<br />
  15. 15. Understanding – Common cold<br />Dr.T.V.Rao MD<br />13<br /><ul><li>leading cause of doctor visits and lost hours both at school and the workplace
  16. 16. over >100 different viruses found to cause symptoms of the common cold
  17. 17. responsible for about 70% of the cases where a virus has been found
  18. 18. one of the most common illnesses to man
  19. 19. 35 to 50% of the total number of common colds
  20. 20. Hand to hand contact</li></li></ul><li>Transmission of Rhinoviruses<br />There are two modes of transmission: via aerosols of respiratory droplets and from contaminated surfaces, including direct person-to-person contact.<br />Dr.T.V.Rao MD<br />14<br />
  21. 21. Pathogenesis - Rhinoviruses<br />Entry through Respiratory tract.<br />Nasal Mucosa, can infect Lower Respiratory tract.<br />Chilling, wearing wet cloths do not produce infection.<br />But common cold starts with chills.<br />Local inflammation and cytokines may be responsible for the symptoms of common cold.<br />Interferon production occurs early and specific antibody appears in nasal secretions<br />Dr.T.V.Rao MD<br />15<br />
  22. 22. Pathogenesis<br />Epithelial destruction hypothesis:<br /><ul><li>intact nasal epithelium (Winther et al)
  23. 23. rhinovirus replication in extremely small number of cells (Arrunda et al)
  24. 24. viral quantity does not influence duration nor severity of colds (Arrunda et al)</li></ul>Dr.T.V.Rao MD<br />16<br />
  25. 25. Pathogenesis<br />Inflammatory cascade hypothesis:<br />Common cold symptoms result from an inflammatory cascade triggered by a viral infection<br />Dr.T.V.Rao MD<br />17<br />
  26. 26. Cytokines initiate pathogenic process<br />Dr.T.V.Rao MD<br />18<br />Small number of virus infected cells elaborate a variety of cytokines initiating a host inflammatory response, which orchestrate chemotaxis and expression of endothelial adhesion receptor molecules resulting in the typical common cold symptoms.<br />
  27. 27. Interleukin-1<br /><ul><li>T-cell activation
  28. 28. B-cell profileration, antibody synthesis
  29. 29. up-regulation adhesion molecule expression
  30. 30. mediator, cytokine, growth factor induction
  31. 31. increased vascular permeabilitiy
  32. 32. up-regulation kinin receptor expression
  33. 33. hematopoietic progenitor cell stimulation
  34. 34. neuro-endocrine interactions</li></ul>Dr.T.V.Rao MD<br />19<br />
  35. 35. Clinical Findings.<br />Incubation 2-4 days,<br />Last for 7 days.<br />Sneezing, Nasal Obstruction, Sore throat,<br />May lead to secondary infection with Bacteria.<br />Dr.T.V.Rao MD<br />20<br />
  36. 36. The common cold, nasal congestion is caused by a vasodilation of the subepithelial capillaries and of the cavernous sinuses, by edema in the lamina propria and by inflammatory processes in which neutrophils and kinins play an important role.<br /><ul><li>Histamine plays only a minor role in the symptoms of common cold
  37. 37. Little is known about the role of prostaglandins and leukotrienes in the common cold.</li></ul>Dr.T.V.Rao MD<br />21<br />
  38. 38. Clinical Findings.<br />Incubation 2-4 days,<br />Last for 7 days.<br />Sneezing, Nasal Obstruction, Sore throat,<br />May lead to secondary infection with Bacteria.<br />Dr.T.V.Rao MD<br />22<br />
  39. 39. Laboratory Diagnosis<br />Isolation of virus may be obtained from nasal or throat swabs collected early in infection.<br />Culturing on MRC5 or W 138<br />Appearing of CPE<br />Dr.T.V.Rao MD<br />23<br />
  40. 40. Immunity – Rhinoviruses.<br />Antibodies in Nose <br />Recurrent infections with antigenic variants, may be 2-3 attacks a year.<br />Dr.T.V.Rao MD<br />24<br />
  41. 41. Prevention and Control<br />No specific treatment.<br />Vaccines are unsuccessful.<br />Intranasal spray of <br /> Gamma Interferon for 5 Days<br />Dr.T.V.Rao MD<br />25<br />
  42. 42. Epidemiology - Rhinoviruses.<br />Prevalent all over the world.<br />Close Contact.<br />Fingers and Hand - Hand washing.<br />High rate of infection in Infants and Children.<br />Dr.T.V.Rao MD<br />26<br />
  43. 43. Dr.T.V.Rao MD<br />27<br />
  44. 44. Use Paper<br />Dr.T.V.Rao MD<br />28<br />Use paper :Instead of shared cloth towels. Individuals with colds should always sneeze or cough into a facial tissue, and promptly throw it away.<br />
  45. 45. Hand washing<br />Dr.T.V.Rao MD<br />29<br />Hand washing is the simplest and most effective way to keep from getting rhinovirus colds. Children and adults should wash hands at key moments after nose-wiping, after diapering or toileting, before eating, and before preparing food.<br />
  46. 46. For Articles of Interest on Infectious diseases and Microbiology follow me on<br />Dr.T.V.Rao MD<br />30<br />
  47. 47. The Programme Created by Dr.T.V.Rao MD for Medical and Health care Workers in the Developing World <br />Email<br />doctortvrao@gmail.com<br />Dr.T.V.Rao MD<br />31<br />