Rhinovirus Infection

Droplet Precautions

Contact Precautions

Rhinovirus, otherwise known as the common cold, is an acute, usually afebrile, viral infection that causes inflammation of the upper respiratory tract. It’s the most common type of infection. In temperate climates, colds occur more often in the colder months; in the tropics, colds are more prevalent during the rainy season.

Colds are usually benign and self-limiting, but they cause more lost time from school or work than any other illness. It is estimated that each person in the United States experiences a cold every 1 to 2 years.

Causes

Rhinovirus causes the common cold in 25% to 80% of cases. A cold is communicable for 2 to 3 days after the onset of symptoms. Transmission occurs through airborne respiratory droplets or through contact with contaminated objects, including hands. High rates of infection are found in day-care centers, nurseries, and schools. The virus has been cultured from inanimate objects up to 4 days after exposure. (See What happens in the common cold.)

Complications

Secondary bacterial infection may cause sinusitis, otitis media, pharyngitis, or lower respiratory tract infection. Infection may exacerbate underlying pulmonary problems, such as chronic obstructive pulmonary disease. Smokers have longer-lasting, more severe infections than nonsmokers.

Assessment Findings

After an incubation period of 1 to 4 days, the patient initially complains of a sore throat, sneezing, coughing, nasal congestion, headache, and mild body aches. Most patients are afebrile, although fever may occur, especially in children.

Clinical features develop more fully as the cold progresses. By the second day (in addition to the initial symptoms), the patient may report copious nasal discharge. About 3 days after onset, major symptoms diminish, but congestion may persist for 7 to 14 days. Re-infection is common, but complications are rare.

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