Runny nose, fever, cough, even pneumonia: The symptoms sound like swine flu, but children hospitalized at one U.S. hospital actually had a rhinovirus — better known as a common cold virus.
Hundreds of children treated at Children's Hospital of Philadelphia had a rhinovirus, and federal health investigators are trying to determine whether it was a new strain and whether this is going on elsewhere in the country.
"What began to happen in early September is we started seeing more children coming to our emergency room with significant respiratory illness," said Dr. Susan Coffin, medical director of infection control and prevention at the hospital.
Doctors and parents assumed it was the new pandemic H1N1 swine flu, which would be expected to re-emerge as schools began in September. But it was not, Coffin said in a telephone interview.
The hospital, unlike most hospitals in the United States, runs a test that can diagnose 10 different respiratory viruses, including influenza but also rhinoviruses, parainfluenza viruses, and other germs that make kids sick.
"The data showed us it wasn't H1N1 but instead was this rhinovirus infection," Coffin said.
Rhinoviruses usually cause an annoying but benign illness that looks a lot like flu, but with more runny nose and usually less of a fever. This one was causing severe symptoms and even pneumonia.
"Some of these kids had really bad wheezing," Coffin said — so bad they had to be hospitalized and treated with a nebulizer, which delivers drugs into the lungs to help keep oxygen in the blood.
"We don't terribly often have large numbers of children test positive for it," Coffin said.
But she estimated that 500 were hospitalized in September and October, with no deaths that she knows of. Starting in mid-October, H1N1 swine flu started to show up, too.
The U.S. Centers For Disease Control and Prevention (CDC) is investigating.
"While rhinovirus outbreaks are common in the fall, the outbreak that occurred this year was unusually large and resulted in a lot of hospital admissions, including many children that required intensive care," said CDC spokesman Dave Daigle. "We're still testing the strains from the outbreak, but from what we've seen so far, it doesn't appear that there's a single predominant strain."
Although swine flu is above epidemic levels, the CDC says only 30 percent of cases of so-called influenza-like illness that are tested actually turn out to be H1N1.
People should not assume that, if they or their children have flu-like symptoms, it was swine flu and they do not need to be vaccinated, Coffin and CDC officials said.
H1N1 has infected an estimated 22 million people and killed 3,900 in the United States alone. It continues to spread globally, and governments are just at the beginning of efforts to vaccinate people against the virus.
There is no vaccine or good treatment for rhinovirus. For severely ill patients hospitals can try to keep blood oxygen levels up and keep the patients hydrated, often with intravenous lines if they are coughing or wheezing too hard to eat or drink.
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