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Cepheid

Cepheid

Editorial Team

4m Read

August 17, 2026

Article

Rhinovirus on a low-plex PCR panel? 3 questions to ask before you test

Molecular PCR panels for upper respiratory infections and pharyngitis are evolving, and clinicians increasingly face choices about which tests for which pathogens are most useful in specific care settings. In outpatient and acute care workflows where decisions need to be made quickly, not every detectable virus carries the same clinical weight.

One topic that continues to raise practical questions is whether rhinovirus belongs on smaller multiplex panels used in outpatient settings, especially when actionability, patient satisfaction, and reimbursement are part of the decision.

3 questions to ask before you decide to test for rhinovirus in outpatient settings:

 

1. What exactly is the test reporting: rhinovirus, or combined “RhV/EV” result?

Rhinovirus (RhV) and enterovirus (EV) are genetically similar, and many on‑market tests do not distinguish between them, even if the report says “rhinovirus.” Enterovirus, while rarer, can cause more severe respiratory disease; specific types have also been associated with acute flaccid myelitis, which causes a polio-like syndrome.1,2 Before interpreting “rhinovirus” as synonymous with “common cold,” it’s worth confirming whether your test can truly tell RhV from EV, or whether the result is combined.

 

2. What decision will this result change today?
In acute workflows, one key consideration is actionability. Unlike SARS-CoV-2, influenza, or RSV, there are no approved antiviral therapies for rhinovirus.3 As a result, a positive result may not directly influence treatment decisions when immediate action is the priority.

3. What else could you be missing?
The clinical value of detecting rhinovirus is further complicated because, not infrequently, it can be found along with other pathogens.4 But if these other pathogens are not also being tested for, then one could be led to think that only RhV(EV) is present. Treat the patient, not a test result.

What this means in acute care and the clinic

These questions don’t argue for or against testing for rhinovirus universally. They’re meant to help providers and care teams align testing choices to biological realities, clinical practice, and the patient populations they serve.

In outpatient and acute care workflows, where speed and clarity drive decision-making, a “rhinovirus” result may not always provide the certainty it appears to offer. Because many tests cannot distinguish between rhinovirus and enterovirus, and because neither result consistently changes immediate management, the clinical value depends heavily on context.

At the same time, a seemingly straightforward result can obscure important nuances, whether that’s the potential presence of enterovirus or other co-circulating pathogens that may be more clinically meaningful.

If the goal is immediate actionability, consider which targets most often change care decisions in your setting. Ultimately, aligning test selection to what will meaningfully change care today can help ensure that molecular diagnostics support, rather than complicate, clinical decision-making.

The content presented on this page is intended for informational and educational purposes. While it is available globally, it may reflect clinical practices or healthcare system considerations specific to a particular region.

References

1. Midgley CM, Watson JT, Nix WA, Curns AT, Rogers SL, Brown BA, et al. Severe respiratory illness associated with a nationwide outbreak of enterovirus D68 in the USA (2014): a descriptive epidemiological investigation. Lancet Respir Med. 2015 Nov;3(11):879–87.

2. Fall A, Norton JM, Abdullah O, Pekosz A, Klein E, Mostafa HH. Enhanced genomic surveillance of enteroviruses reveals a surge in enterovirus D68 cases, the Johns Hopkins health system, Maryland, 2024. J Clin Microbiol. 2025;63(7):e00469-25. doi:10.1128/jcm.00469-25

3. Rahajamanana, V. L., Thériault, M., Rabezanahary, H., Sahnoun, Y. G., Mallet, M. C., Isabel, S., Trottier, S., & Baz, M. (2025). Advances in the Treatment of Enterovirus-D68 and Rhinovirus Respiratory Infections. Infectious Disease Reports, 17(3), 61. https://doi.org/10.3390/idr17030061

4. Amarin JZ, Potter M, Thota J, et al.  Clinical characteristics and outcomes of children with single or co-detected rhinovirus-associated acute respiratory infection in Middle Tennessee. BMC Infect Dis. 2023;23:136

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