Epidemiological Characteristics and Co-Detection Patterns of Rhinovirus (A/B/C) and Influenza A Virus in a Regional...

To characterize the epidemiological profile, coinfection spectrum, and virus-virus association patterns between rhinovirus (RV; A/B/C) and influenza A virus (IAV).

We analyzed 8928 respiratory samples collected from April 2023 to December 2025. A quality-controlled RV analytic cohort (n = 386) and an IAV-positive cohort (n = 422) were used for subtype distribution, coinfection profiling, and observed-versus-expected co-occurrence analysis. Associations were evaluated with Fisher's exact test or chi-square test, with odds ratios (ORs) and 95% confidence intervals (CIs).

In the RV cohort, subtype A was dominant (235/386, 60.9%), followed by C (118/386, 30.6%) and B (33/386, 8.5%); mixed subtypes accounted for 1.6% (6/386). Coinfection was common (282/386, 73.1%), and IAV was detected in 14/386 RV-positive samples. Co-occurrence analysis showed lower-than-expected overlap for IAV-RV A (0.23% vs. 0.40%), IAV-RV B (0.029% vs. 0.099%), and IAV-RV A/B/C overall (0.390% vs. 0.624%), while IAV-RV C was close to random expectation (0.217% vs. 0.210%).

RV and IAV exhibited subtype-dependent interaction patterns in this regional cohort, with apparent mutual exclusion for RV-A/RV-B and near-random coexistence for RV-C. These findings support subtype-stratified surveillance and season-specific prevention strategies.