Fatal Respiratory Infections Associated with Rhinovirus Outbreak, Vietnam

Le Thanh Hai, Vu Thi Ngoc Bich, Le Kien Ngai, Nguyen Thi Ngoc Diep, Phan Huu Phuc, Viet Pham Hung, Walter R. Taylor, Peter Horby, Nguyen Thanh Liem, and Heiman F.L. Wertheim

Author affiliations: National Hospital of Pediatrics, Hanoi, Vietnam (L.T. Hai, L.K. Ngai, P.H. Phuc, V.P. Hung, N.T. Liem); Wellcome Trust Major Overseas Program Vietnam, Hanoi (V.T.N. Bich, N.T.N. Diep, W.R. Taylor, P. Horby, H.F.L. Wertheim); Oxford University Clinical Research Unit, Hanoi (W.R. Taylor, P. Horby, H.F.L. Wertheim); and University of Oxford, Oxford, UK (W.R. Taylor, P. Horby, H.F.L. Wertheim)

Abstract

During an outbreak of severe acute respiratory infections in 2 orphanages, Vietnam, 7/12 hospitalized children died. All hospitalized children and 26/43 children from outbreak orphanages tested positive for rhinovirus versus 9/40 control children (p = 0.0005). Outbreak rhinoviruses formed a distinct genetic cluster. Human rhinovirus is an underappreciated cause of severe pneumonia in vulnerable groups.

The World Health Organization estimates that ≈2 million children die each year from acute respiratory tract infection (ARI), and most live in developing countries (1). Human rhinovirus (HRV), a common cause of mild upper respiratory tract infections, may also cause severe ARI in children. We report on an outbreak of severe ARI caused by HRV in children living in orphanages in Vietnam.