Most common cause of upper respiratory infection?

JIPMER Nursing Officer - 2020

Microbiology

Easy

Appeared in: JIPMER Nursing Officer - 2020

Explanation

Rhinoviruses are the most common viral infective agents in humans and the single most frequent cause of the common cold, an upper respiratory infection.
Studies indicate that rhinoviruses are responsible for at least 50% of all common cold cases.
The virus belongs to the Picornaviridae family and has over 100 serotypes, which contributes to its high prevalence and the frequency of reinfection.
Transmission occurs year-round via contaminated secretions, with peaks in fall and spring.

Option B: Adenoviruses cause a range of respiratory illnesses, but they account for a smaller percentage (estimated 5-10%) of childhood respiratory diseases and are not the most common cause of URIs in the general population.
Option C: While coronaviruses are a major cause of respiratory illness (including the common cold and more severe diseases like COVID-19), endemic human coronaviruses are generally considered the second most common cause of the common cold, after rhinoviruses.
Option D: HAV (Hepatitis A Virus) is an incorrect option because it is not a respiratory virus. It infects the liver and is transmitted via the fecal-oral route, typically through contaminated food or water.

Clinical Relevance

Nursing practice connection: Knowing Etiology of Upper Respiratory Infections helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Understanding that most URIs are caused by viruses like Rhinovirus is crucial for patient education, particularly in explaining why antibiotics are ineffective and should not be prescribed, thus combating antibiotic resistance.
Nurses can emphasize preventive measures like frequent handwashing, as rhinoviruses are hardy and can persist on surfaces, making fomite transmission a significant factor.
What if? If the patient with a URI is a military recruit living in a barracks, a nurse should have a higher index of suspicion for Adenovirus, which is known to cause outbreaks in such crowded conditions.

How to Approach the Question

First, analyze the question to identify the key directive: find the 'most common cause' of 'upper respiratory infection'.
Recognize that 'upper respiratory infection' is often synonymous with the 'common cold'.
Evaluate the options based on general medical and virological knowledge.
Eliminate any obviously incorrect options. In this case, 'HAV virus' (Hepatitis A) affects the liver and is transmitted differently, so it can be immediately discarded.
Compare the remaining respiratory viruses (Rhinovirus, Adenovirus, Coronavirus). Recall or deduce their relative prevalence in causing the common cold.
Select the agent that is most frequently cited as the primary cause, which is Rhinovirus.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 2041-2043

E6 Medicine Harrison 22e Part 1 p. 1575-1577