Rhinovirus Vs Pneumonia

Rhinovirus is a virus which is the most common cause of the common cold, whereas pneumonia is an infection of one or both lungs which is caused by either a virus, bacteria, or fungi. This article will aim to give an overview on both rhinovirus and pneumonia, compare their similarities and differences and how they can be treated. The key points of this article include:

• Rhinovirus is a virus which may, after infection, lead to upper-respiratory tract infection, in particular, the common cold
• Rhinovirus infections are generally not serious and have limited medical complications
• Rhinovirus is also associated with the exacerbation of other lower-respiratory tract medical complications, such as asthma, cystic fibrosis, and pneumonia
• Pneumonia is an infection of the lung(s) caused by either viruses, bacteria, or fungi
• The seriousness of pneumonia ranges from mild to life-threatening
• Rhinovirus and pneumonia are both acquired through breathing in infected droplets in the air, normally from an infected person coughing or sneezing
• The symptoms of pneumonia and rhinovirus are very similar, but they are more severe with pneumonia
• Rhinovirus generally goes away on its own and doesn’t require treatment, whereas pneumonia is usually treated with antibiotics

Overview

Rhinovirus

Rhinovirus is a type of virus. Viruses can be defined as infectious microbes which infect cells and use the host cell to replicate themselves. This often leads to the host cell dying, which consequently damages the host organism.¹ Rhinoviruses are the most prevalent type of virus which infect humans and are commonly associated with causing the common cold. Rhinovirus infections are typically seasonal and within these periods of increased incidence rhinoviruses may be associated with up to 80% of common cold illnesses.² The symptoms of the common cold and consequently also rhinovirus, include:³

• Blocked/runny nose
• Headache
• Sore throat
• Muscle ache
• Coughing
• Sneezing
• High temperature
• Loss of taste and smell
• Pressure in ears and face

Despite the symptoms of the common cold not being particularly severe, they are still associated with having a considerable effect on society. For example, common cold infections often lead to individuals missing school/work and seeking unnecessary medical care. However, although most rhinovirus infections lead to the development of the manageable common cold, rhinoviruses are also associated with other medical complications. These include acute otitis media (middle ear infection) and sinusitis. Furthermore, as well as rhinovirus causing upper respiratory tract infections, they are also associated with lower respiratory tract symptoms, which are often more serious. One of the most prevalent medical conditions that rhinovirus infection can lead to is asthma, with it being associated with 60-70% asthma exacerbations in school-age children. Additionally, studies have shown that rhinovirus infection may be linked to exacerbating cystic fibrosis in children and chronic bronchitis in adults.²

As well as directly leading to medical complications (particularly of the upper respiratory tract) studies have shown that rhinovirus infection may predispose individuals to a further infection by bacteria. For example, rhinovirus increases the chance of developing bacterial pneumonia.² Therefore, this shows how important it is to treat rhinovirus infection as early as possible, in order to decrease the chance of further serious infections developing.

Pneumonia

Pneumonia can be defined as an infection of one or both lungs, specifically of the air sacs in the lung called alveoli. After pneumonia infection, these air sacs may fill with fluid or pus, leading to a range of symptoms, including:⁴

• Chest pain when breathing/coughing
• Cough that may produce phlegm
• Fever
• Shortness of breath
• Fatigue
• Nausea, vomiting and diarrhoea
• Confusion or changes in mental awareness (generally in adults over the age of 65)

A variety of different disease microbes including viruses, bacteria, and fungi can lead to the development of pneumonia. However, bacterial infection is the most common cause.  Additionally, the seriousness of pneumonia can range from mild to life-threatening. Pneumonia infection is particularly serious for young children, people with a weakened immune system caused by other health problems, and for adults over the age of 65.⁴ Therefore, pneumonia presents as a significant cause of mortality and medical complications worldwide.⁵

Pneumonia can be broadly separated into community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). The number of pneumonia cases vary depending on geographic location, healthcare accessibility, and population. Lower respiratory tract infections, which include pneumonia, are the fourth most common cause of death worldwide. Generally, the incidence of CAP increases with age and in colder weather. Additionally, CAP is the most common cause of infection-related death globally. Therefore, it is extremely important that better treatment interventions are developed.⁵  

Pneumonia is caused by the invasion and overgrowth of disease microbes invading the air sacs of the lung; they typically enter the lower respiratory tract through microaspiration (unintentional aspiration of small amounts of reflux material). This can lead to infection when the disease microbes defeat the body’s natural defence mechanisms. The infection may also spread from the lungs, leading to a range of medical complications, including sepsis and meningitis. Bacterial pneumonia is usually associated with sudden onset of symptoms and rapid disease progression. In comparison, viral pneumonia typically develops from a slow-onset upper-respiratory tract infection and is more commonly associated with children.⁵

With low-severity CAP, investigation and treatment is not usually needed. However, if the patient has more severe symptoms, further investigation is required. This is so that doctors can analyse how severe the infection is and what caused it so that the most effective treatment plan can be formulated. These tests normally involve:⁵

• Chest X-ray
• Blood tests
• Urine test
• Rapid diagnostic tests

What is the difference between pneumonia and rhinovirus?

The main difference between pneumonia and rhinovirus is that pneumonia is an infection caused by several different types of disease microbes, whereas rhinovirus is a specific type of virus and not a type of infection. Infection by rhinovirus usually leads to the development of the common cold, which is a mild infection of the nose and throat (upper respiratory system).⁶ Therefore, infection by rhinovirus normally doesn’t need further treatment and generally does not lead to medical complications. In comparison, pneumonia severity can range from mild to life-threatening and consequently often individuals with a pneumonia infection need further investigation and treatment.

The symptoms of pneumonia and rhinovirus are also slightly different. Although many of the symptoms of pneumonia are the same as rhinovirus, typically individuals with a pneumonia infection will have additional more extensive symptoms than a common cold, for example, chest pain. Furthermore, a common cold normally clears up by itself within one or two weeks and does not require further treatment, whereas it may take up to 3-6 months for individuals to start feeling well after a pneumonia infection. Pneumonia infections also often need treatment using antibiotics or even hospitalisation.⁶

What are the similarities between pneumonia and rhinovirus?

As previously mentioned, pneumonia and rhinovirus share some similar symptoms. This is due to them both being infections of the respiratory system, with rhinovirus normally causing upper respiratory tract infections and pneumonia being a lower respiratory tract infection. Another similarity is that both pneumonia and rhinovirus are usually spread through droplets in the air that people breathe in. Therefore, an infected person coughing, and sneezing may lead to someone nearby developing the respective infection.⁷

How serious are rhinovirus and pneumonia?

Rhinovirus is not generally serious and usually only leads to mild symptoms. However, although rarely, rhinovirus infection can lead to serious medical complications, such as:

• Otitis media (middle ear infection)
• Chronic bronchitis
• Sinusitis

Rhinovirus infection developing into more severe lung infections such as bronchitis and pneumonia usually only happens in babies or in children who have other health problems. Additionally, rhinovirus presents as a serious risk and is potentially life-threatening for people with cancer.⁸

In comparison, pneumonia is normally more severe than a rhinovirus infection, with cases ranging from mild to life-threatening. As previously mentioned, community-acquired pneumonia is the most common cause of infection-related mortality. Therefore, normally pneumonia is more serious than rhinovirus.

How are rhinovirus and pneumonia treated?

As rhinovirus infections are normally mild, they tend to go away on their own. However, there are some treatments which can provide relief from the infection, including:⁸

• Rest
• Hydration
• First generation antihistamines
• Nasal decongestants

Treatment for pneumonia involves treating the infection and preventing complications. People with CAP normally can be treated at home with medications, which include:⁹

• Antibiotics (only prescribed for bacterial pneumonia)
• Cough medicine
• Fever reducers/pain relievers

Some people with severe pneumonia may need to be hospitalised, this is generally only for people over the age of 65 or for young children.⁹

Summary

Rhinovirus and pneumonia both affect the respiratory system. Rhinovirus infection usually leads to the development of an upper respiratory tract infection, predominantly the common cold. It generally only leads to mild symptoms but sometimes it can exacerbate other health problems or even lead to the development of more severe illnesses. In comparison, pneumonia is an infection of the air sacs in the lung (lower respiratory tract) and its severity can range from mild to life-threatening. Pneumonia can be caused by a variety of different disease microbes, but it is mostly caused by bacteria. As both rhinovirus and pneumonia affect the respiratory system, they are both acquired through breathing in infected droplets in the air, this is usually through an infected person coughing or sneezing. They also share similar symptoms, but generally, the symptoms of pneumonia are more severe. As rhinovirus infections are usually mild, they normally go away on their own and no further treatment is needed. However, treatment is needed for individuals with pneumonia, this is most commonly antibiotics. Some people, particularly the elderly and very young, may need to be hospitalised to properly treat pneumonia.