Prevalence and Clinical Characteristics of Pediatric Rhinovirus Infection During Winter in Erbil City, Iraq

Respiratory infections remain the leading infectious cause of childhood morbidity and mortality worldwide, particularly affecting children under five. Viral pathogens cause approximately 80% of pediatric acute respiratory tract infections (ARTIs), with human rhinovirus (HRV) emerging as an etiological agent associated with both mild and severe infections. This cross-sectional study was conducted to investigate the criteria of ARTI in 177 pediatric patients aged ≤ 5 years who visited Raparin Teaching Hospital for Children from December 1st 2024 to the 28th of February 2025. Following nucleic acid extraction, multiplex real-time RT-PCR was used for the detection of HRV. Among the studied 177 pediatric patients with ARTIs, 98 (55.4%) were admitted to the hospital and 79 (44.6%) received treatment and were sent home (outpatients). Their mean age was 12.38 ± 10.56 months, with male predominance (56.5%). Cough (99.4%), fatigue (99.4%), and fever (98.3%) were the most frequent symptoms. Auscultation revealed wheezing (54.8%) and rales (22.6%) as the main lung sounds, with significantly higher rates in inpatients versus outpatients (58.2% vs. 50.6%, p = 0.03; 26.5% vs. 19.0%, p = 0.02, respectively). Rhinovirus was detected in 15 cases (8.5%), predominantly associated with bronchiolitis (46.7%) and bronchitis (40.0%). A temporal clustering was observed, with 60% of HRV-positive cases occurring in January and 40% in February (p = 0.044). Conclusion: This study highlighted rhinovirus as an important pathogen in pediatric ARTIs in Erbil city, predominantly causing bronchiolitis and bronchitis. The high rates of wheezing and rales-particularly among inpatients-suggested that these clinical signs may serve as severity markers. These findings underscore the need for routine HRV screening in pediatric respiratory cases to guide management and infection control measures.