3 Discussion
The “common cold” was not generally concerned by the general public
for the mild symptoms, however, there were more than 250 virus serotypes
could led to the “common cold” symptoms, and human rhinovirus (HRV)
has long been known for the main pathogens of the “common
cold”2,8, Cui and colleagues9 have
reported that among the influenza like illness (ILI), 6.46% of which
were tested positive for HRV, another study conducted by Lan Zhaoet al 10 reported that 11.28% of the acute
respiratory viral infection were caused by HRV infection. Yuki Furuseet al 11. also found that rhinoviruses were the
most frequently detected pathogen (22.2%) among the acute respiratory
infection (ARI) cases, the hospitalized population would have a higher
positive rate of HRV12.
A study conducted by Dr. Luka and colleges13 in Kenya
had reported that the common cold caused by HRV was mainly detected
among school-going children or teenagers with a mild acute respiratory
symptoms. However, the HRV infected adults were had a relative higher
mortality and longer hospitalization than that of the patients infected
influenza viruses in the elderly population14. Dr.
Park15 analyzed the etiological surveillance data of
respiratory viruses in South Korea from 2016 to 2019 and 2020, and found
that the enveloped respiratory viruses (human coronavirus, HCoV,
non-SARS-COV-2; human metapneumovirus, HMPV; influenza virus, IFV;
parainfluenza virus, PIV; respiratory syncytial virus, RSV) were
effectively controlled at the COVID-19 control measures in 2020, while
non-enveloped respiratory viruses (adenovirus, ADV; human rhinovirus,
HRV; human bocavirus, HBoV) were not effectively controlled during this
period, and among hospitalized cases, the proportion of hospitalizations
due to rhinovirus infection was significantly increased. A study
conducted by Dr. Zhang16 observed a sharp increase of
the positive rate of HRV in Beijing, China, and reasonably assumed to be
explained by the reopening of the primary and secondary schools of
Beijing. Another study17 conducted in Southampton, UK,
gave a theory that the HRV was mainly found in children and adolescents
whom were the major reservoir for HRV infection, social distancing and
face masks are not effective in preventing transmission of HRV, with
“Back-to-School Upper Respiratory Infection ”
effect18, the risk of HRV transmission surges after
schools reopening. On the other hand, Dr. Nancy
Leung19 conducted experiments and proved that there
was no significant difference in filtering or protection effect of HRV
between wearing a face mask or not, indicating that wearing masks cannot
effectively protect the population from the HRV infection.
Our previous studies20-22 have showed that when
combated with the COVID-19 pandemic, measures had been taken to stop the
transmission of the SARS-COV-2, and respiratory virus like influenza
virus, varicella, herpes zoster, rubella, measles, mumps virus were
observed all dramatically decreased during the fighting against COVID-19
pandemic, however, HRV was found remains prevalent in school
teenagers23.
In our study, most of the outbreaks were reported the primary and
secondary schools of Guangzhou, China, which was agree with the Dr.
Martha’s and Dr. Zhang’ s study13,16. 74% of the
patients in our study were recorded had fever, 30% of the patients had
sore throat and runny nose, 19% of the patients had cough and 8% of
the patients had sneeze, so the most typical symptom of HRV infection in
our study was fever. By sampling and testing, we found that patients
with the symptoms of fever, cough, runny nose and sneezing were more
likely to test positive for HRV in a HRV related outbreak. Study have
proved that HRV infection in youngsters would be symptomatic while in
adults often asymptomatic24.
Diurnal temperature range (DTR) was reported to be one of the risk
factors of the common cold, which gives the answer to the trend of the
endemic of HRV in spring and winter of the year25.
Obesity was another risk factor reported to rise the possibility of HRV
infection26. While in our study, we did not collect
the DTR, height and weight data of the patients, which is a shortcoming
of this study.
In summary, this study gives a glimpse of the endemic of HRV in
Guangzhou, China, proved better evidence for the prevention and control
of respiratory viruses, and indicated that the conventional COVID-19
control measures, such as wearing face masks or social distancing, are
not effective enough in preventing rhinovirus, so new masks that filter
non-enveloped viruses, including HRV, should be considered as a possible
new approach to preventing HRV infection.
Funding: This work was supported by the Natural Science
Foundation of Guangdong Province (2019A1515011407), Medical Science and
Technology Project of Guangzhou (20201A011067,20211A011059), Guangdong
Medical Science and Technology Research Project (A2019379, A2020399,
B2021244).
Conflicts of Interest: No conflict of interest to declare by
all authors
ORCID: Di Wuhttps://orcid.org/0000-0003-2462-4232
Ethical Approval Statement: The ethical approval or individual
consent was not applicable.