The Clinical and Genomic Epidemiology of Rhinovirus in Homeless Shelters-King County, Washington

J Infect Dis. 2022 Oct 7;226(Suppl 3):S304-S314. doi: 10.1093/infdis/jiac239.


Background: Rhinovirus (RV) is a common cause of respiratory illness in all people, including those experiencing homelessness. RV epidemiology in homeless shelters is unknown.

Methods: We analyzed data from a cross-sectional homeless shelter study in King County, Washington, October 2019-May 2021. Shelter residents or guardians aged ≥3 months reporting acute respiratory illness completed questionnaires and submitted nasal swabs. After 1 April 2020, enrollment expanded to residents and staff regardless of symptoms. Samples were tested by multiplex RT-PCR for respiratory viruses. A subset of RV-positive samples was sequenced.

Results: There were 1066 RV-positive samples with RV present every month of the study period. RV was the most common virus before and during the coronavirus disease 2019 (COVID-19) pandemic (43% and 77% of virus-positive samples, respectively). Participants from family shelters had the highest prevalence of RV. Among 131 sequenced samples, 33 RV serotypes were identified with each serotype detected for ≤4 months.

Conclusions: RV infections persisted through community mitigation measures and were most prevalent in shelters housing families. Sequencing showed a diversity of circulating RV serotypes, each detected over short periods of time. Community-based surveillance in congregate settings is important to characterize respiratory viral infections during and after the COVID-19 pandemic.

Clinical trials registration: NCT04141917.

Keywords: COVID-19 pandemic; congregate setting; epidemiology; genomic analysis; homeless shelter; people experiencing homelessness; respiratory pathogen; respiratory viral infection; rhinovirus.

Publication types

  • Clinical Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, N.I.H., Extramural

MeSH terms

  • COVID-19* / epidemiology
  • Cross-Sectional Studies
  • Enterovirus Infections* / epidemiology
  • Genomics
  • Humans
  • Ill-Housed Persons*
  • Pandemics
  • Rhinovirus / genetics
  • Viruses*
  • Washington / epidemiology

Associated data