Diversity of Rhinovirus and Enterovirus Infections Among Pediatric Patients Hospitalized in Wisconsin, 2022–2023

Severe rhinovirus (RV)/enterovirus (EV) respiratory infections in pediatric patients increased in the US during 2022-2023. This study aimed to characterize RV/EV genetic diversity among hospitalized children in Wisconsin and describe demographic and clinical factors of patients by RV/EV type. During September 2022-April 2023, five Wisconsin pediatric hospitals submitted five RV/EV-positive specimens weekly to CDC. Viral typing was performed using partial viral protein (VP) 4/VP2 (RV) and VP1 (EV) sequencing. Wisconsin Department of Health Services abstracted demographic, comorbid condition, and hospitalization course information from patient medical records. Ninety-six patients were included in this investigation. RV-C (n = 40, 42%) and RV-A (n = 31, 32%) were the most frequently detected species, with 46 RV and 5 EV types identified. The median age was 2.5 (IQR: 0.7-5.5) years. Seventy-one (74%) children had at least one comorbid condition. Asthma was more common among children with RV-C infections (n = 12, 30%) compared with other RVs (n = 3, 9%) (p = 0.02). RV-A and RV-C were important contributors to severe pediatric respiratory infection in Wisconsin. Molecular typing showed virus divergence typically observed during season-long investigations. Year-round molecular characterization is needed to better understand the contribution of RV/EV types to severe pediatric respiratory illness.