TABLE 2

Diseases and disorders associated with respiratory viral pathogensa

Virus(es)Respiratory diseases and disordersCommentsKey references
ADVPharyngitis, common cold, laryngitis, bronchitis, bronchiolitis, pneumoniaMain cause of pharyngitis in infants and children; types 4 and 7 caused pneumonia in military recruits; multiplex NAAT-based assays which include ADV are available; latency and persistent shedding can confound interpretation of qualitative tests(130, 236, 281, 345349)
CoVs NL63, OC43, HKU1, 229E, SARS-CoV, and MERS-CoVCommon cold, pharyngitis, laryngitis, bronchitis, bronchiolitis, pneumonia, SARS, MERSMultiplex NAAT-based assays are available for the detection and differentiation four genotypes of CoV (229E, OC43, NL63, and HKU1); genotypes such as SARS-CoV and MERS-CoV can be detected only by NAAT, often at reference/public health laboratories(236, 348356)
EVBronchiolitis, bronchitis, common cold, pharyngitis, pleurodyniaEV-D68 is associated with severe respiratory illness outbreaks in the USA (2014); multiplex NAAT-based assays which include EV are available; as described in the text, many panels cannot differentiate between EV and RV or detect all types of EV (e.g., EV D68); LDTs have been utilized for typing(236, 357, 358)
hMPVBronchiolitis, common cold, laryngitis, bronchitis, pneumoniahMPV infection is associated with a substantial burden of hospitalizations and outpatient visits among children throughout the first 5 years of life, especially during the first year; elderly adults also susceptible; multiplex NAAT-based assays are available for hMPV detection; two groups and four subgroups of hMPV can be detected and identified by molecular assays(236, 281, 348, 349, 359, 360)
RVsBronchiolitis, bronchitis, common cold, pharyngitis, pneumoniaThe leading pathogen causing common cold and the most common viral cause (8%) of pneumonia in adults in the USA; multiplex NAAT-based assays are available for RV detection; molecular assays are the only method for detection of RV genotype C; some molecular panels cannot distinguish between RV and EV(236, 348, 349, 358, 361363)
FLUA (including subtypes H1, H3, and H5) and FLUBBronchitis, bronchiolitis, common cold, influenza, laryngitis, pharyngitis, pneumoniaCommon pathogen of pneumonia in adults; multiplex NAAT-based assays are available for FLUA detection; on-demand and point-of-care molecular tests are available; genotyping and subtyping can be done by molecular assays; clinical relevance of viral load determination merits further investigation(236, 281, 286, 348, 349, 361, 364366)
PIVs 1–4Bronchiolitis, bronchitis, common cold, laryngitis, otitis media, pharyngitis, pneumoniaPIV 1 and PIV 3 are the most common types causing bronchitis; PIV 4 has not been confirmed to be a definite pathogen in humans; multiplex NAAT-based assays are available, including detection and differentiation of PIVs 1–4(236, 281, 349, 354)
RSVA and -BBronchiolitis, bronchitis, common cold, otitis media, pneumoniaLeading cause of bronchiolitis and common pathogen of pneumonia in children; disease severity is significantly associated with viral load rather than RSV subgroup; multiplex NAAT-based assays are available for RSV, and some of them provide subgroup information on RSVA and RSVB(236, 348, 349, 367369)
  • a Abbreviations: ADV, adenovirus; SARS, severe acute respiratory syndrome; MERS, Middle East respiratory syndrome; CoV, coronavirus; EV, enterovirus; hMPV, human metapneumovirus; RV, human rhinovirus; FLU, influenza virus; PIV, parainfluenza virus; RSV, respiratory syncytial virus; NAAT, nucleic acid amplification test; LDT, laboratory-developed test.