Clinical Scorecard: Genomic Analysis and Evolutionary Trends of Rhinovirus in Western Washington State, 2021–2022
At a Glance
Category
Detail
Condition
Human rhinovirus infection causing common cold and respiratory illnesses
Key Mechanisms
High genomic diversity with multiple cocirculating genotypes and intergenotypic recombination; viral load correlates with symptom presence
Target Population
Symptomatic and asymptomatic individuals in Western Washington State, including immunocompromised and patients with respiratory comorbidities
Care Setting
Outpatient community testing sites and hospital surveillance
Key Highlights
Sequenced 1078 rhinovirus genomes revealing 99 of 168 known genotypes cocirculating with dynamic genotype cluster swapping between 2021 and 2022.
Significant association found between viral load and symptom presence, but no association with RV species or genotype.
High amino acid constraints observed throughout the polyprotein with evidence of intragenotype evolution and intergenotypic recombination.
Guideline-Based Recommendations
Diagnosis
Use reverse transcription quantitative polymerase chain reaction (RT-qPCR) for rhinovirus detection from nasal swabs.
Consider viral load measurement as it correlates with symptom presence.
Management
Recognize rhinovirus as a cause of upper and lower respiratory infections, especially in immunocompromised and patients with asthma or chronic lung diseases.
No broadly reactive vaccine available due to high genotype diversity; management remains supportive.
Monitoring & Follow-up
Surveillance of circulating rhinovirus genotypes is important to understand epidemiology and viral evolution.
Monitor for outbreaks especially during periods of altered circulation of other respiratory viruses.
Risks
Immunocompromised individuals are at risk for severe lower respiratory tract infections with high mortality.
Rhinovirus can exacerbate asthma, cystic fibrosis, and chronic obstructive pulmonary disease.
Patient & Prescribing Data
Outpatients attending COVID-19 community testing sites, including symptomatic and asymptomatic individuals
No specific antiviral treatment; viral load correlates with symptoms but genotype does not influence clinical presentation.
Clinical Best Practices
Collect nasal swabs for RT-qPCR testing in patients with respiratory symptoms or for surveillance.
Interpret viral load data to assess symptom correlation but do not rely on genotype for clinical decision-making.
Maintain awareness of rhinovirus circulation even during pandemics affecting other respiratory viruses.
Support ongoing genomic surveillance to inform epidemiology and potential vaccine development.
by Stephanie Goya, Seffir T Wendm, Hong Xie, Tien V Nguyen, Sarina Barnes, Rohit R Shankar, Jaydee Sereewit, Kurtis Cruz, Ailyn C Pérez-Osorio, Margaret G Mills, Alexander L Greninger
