Rhinovirus Infection in Acute Exacerbations of Chronic Bronchitis: A Controlled Prospective Study

Abstract

Natural rhinovirus infection in adults is usually associated with an afebrile coryzal syndrome (Hobson and Schild, 1960 ; Hamre and Procknow, 1961 ; Reilly et al., 1962 ; Forsyth et al., 1963), and, depending on the population studied, rhino viruses as a group are associated with 8 to 25% of minor upper respiratory illnesses in adults and from 5 to 20% of such illnesses in children (Tyrrell and Bynoe, 1961 ; Johnson et al., 1962 ; Kendall et al., 1962 ; Bloom et al, 1963 ; Hamparian et al., 1964). Forsyth et al. (1963) found in Servicemen from whom rhinoviruses were isolated that 50% experienced chest pain and 86% reported a cough. Taylor-Robinson et al. (1963) and Hamparian et al, (1964) each reported the isolation of a rhinovirus from an adult with bronchitis. In the collaborative study on the aetiology of acute respiratory infections in Great Britain ?From 1961 to 1964, 179 patients were reported as having bronchitis. No indication was given regarding the age of the subjects, but 23% were associated with infective agents and in four instances rhinoviruses were isolated (Medical Research Council, 1965b). In a direct study of 15 chronic bronchitis patients over a period of two and a half years, Eadie et al. (1966) studied 75 acute respiratory illnesses and reported the isolation of 12 rhinoviruses. Eleven rhinoviruses were isolated from 47 illnesses affecting the chest, whereas only one rhino virus was isolated from 28 illnesses not affecting the chest. The only other study of acute exacerbations of bronchitis which employed techniques for rhinovirus isolation failed to detect these agents (Carilli et al., 1964). The purpose of this paper is to report the findings of a controlled prospective study designed to determine the signi ficance of rhinovirus infection on the aetiology of acute exacerbations in patients with chronic bronchitis and to describe the clinical picture associated with such infections.