Enterovirus D-68 in Critically-Ill Children: A Comparison to Pandemic H1N1 Influenza

Rao, Suchitra; Holzberg, Jeffrey; Rick, Anne-Marie; Montano, Aaron; Messacar, Kevin; Torok, Michelle; Bagdure, Dayanand; Curtis, Donna; Oberste, Steve; Nix, W. Allan; Dominguez, Samuel R.

doi:10.1093/ofid/ofv133.386

Cited by 8 publications

(14 citation statements)

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“…However, the age range of those reported was wide (3 days—92 years) and case reporting derived primarily from children's hospitals likely skewed the data towards the pediatric age group [Midgley et al, ]. More than half of children identified with confirmed EV‐D68 infection were noted to have a prior history of asthma and these children were more frequently admitted to the ICU [Midgley et al, ; Rao et al, ; Schuster et al, ]. Infections leading to severe respiratory disease in adults with hematologic malignancy and those undergoing hematopoietic cell and solid organ transplants were also reported [Waghmare et al, ].…”

Section: Epidemiology Of the 2014 Enterovirus D68 Outbreak In North Amentioning

confidence: 99%

“…Children with laboratory‐confirmed EV‐D68 during the 2014 North American outbreak most commonly presented with asthma‐like symptoms of shortness of breath, cough, and wheezing; increased work of breathing, diminished breath sounds, and hypoxia were noted on exam [Midgley et al, ; Rao et al, ; Schuster et al, ]. Fever was noted in only a quarter to half of children with confirmed infection [Midgley et al, ; Schuster et al, ].…”

Section: Clinical Manifestations and Managementmentioning

confidence: 99%

“…Fever was noted in only a quarter to half of children with confirmed infection [Midgley et al, ; Schuster et al, ]. Chest radiographs were frequently abnormal, primarily consisting of nonfocal findings of airways disease, with focal infiltrates in a minority [Rao et al, ; Schuster et al, ]. Children generally had normal to mildly elevated white blood cell counts and C‐reactive protein levels [Rao et al, ; Schuster et al, ].…”

Section: Clinical Manifestations and Managementmentioning

confidence: 99%

“…Chest radiographs were frequently abnormal, primarily consisting of nonfocal findings of airways disease, with focal infiltrates in a minority [Rao et al, ; Schuster et al, ]. Children generally had normal to mildly elevated white blood cell counts and C‐reactive protein levels [Rao et al, ; Schuster et al, ]. Bacterial coinfections were uncommonly reported [Schuster et al, ] (Table ).…”

Section: Clinical Manifestations and Managementmentioning

confidence: 99%

“…The vast majority of children with severe disease were managed with supplemental oxygen, bronchodilators, and steroids, typical of asthma management. Use of continuous albuterol and second line asthma medications including magnesium, terbutaline, aminophylline, and epinephrine is indicative of the high acuity observed among affected children [Rao et al, ; Schuster et al, ]. Of hospitalized children with confirmed EV‐D68 infection described in the U.S., a majority (59%) were admitted to the ICU, although disproportionate testing among cases of severe disease skews these data [Midgley et al, ].…”

Section: Clinical Manifestations and Managementmentioning

confidence: 99%

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2014 outbreak of enterovirus D68 in North America

Messacar

Abzug

Dominguez

2015

Journal of Medical Virology

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Enterovirus D68 (EV-D68) is an emerging picornavirus which causes severe respiratory disease, predominantly in children. In 2014, the largest and most widespread outbreak of EV-D68 described to date was reported in North America. Hospitals throughout the United States and Canada reported surges in patient volumes and resource utilization from August to October, 2014. In the US a total of 1,153 infections were confirmed in 49 states, although this is an underestimate of the likely millions of cases that occurred but were not tested. EV-D68 was detected in 14 patients who died; the role of the virus in these deaths is unknown. A possible association between EV-D68 and cases of acute flaccid paralysis with spinal cord gray matter lesions, known as acute flaccid myelitis, was observed during the outbreak and is under investigation. The 2014 outbreak of EV-D68 in North America demonstrates the public health importance of this emerging pathogen.

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Section: Epidemiology Of the 2014 Enterovirus D68 Outbreak In North Amentioning

confidence: 99%

Section: Clinical Manifestations and Managementmentioning

confidence: 99%

Section: Clinical Manifestations and Managementmentioning

confidence: 99%

Section: Clinical Manifestations and Managementmentioning

confidence: 99%

Section: Clinical Manifestations and Managementmentioning

confidence: 99%

See 3 more Smart Citations

2014 outbreak of enterovirus D68 in North America

Messacar

Abzug

Dominguez

2015

Journal of Medical Virology

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Surveillance of enteroviruses from paediatric patients attended at a tertiary hospital in Catalonia from 2014 to 2017

Andrés

Vila

Gimferrer

et al. 2019

Journal of Clinical Virology

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A B S T R A C TBackground: Enterovirus (EV) infections are usually asymptomatic or mild, but symptomatic infections can evolve to severe complications. Outbreaks of EV-A71 and EV-D68 have been recently reported worldwide, sometimes related to severe clinical outcomes. Objective: To describe EV genetic diversity and the clinical outcomes from paediatric patients attended at a tertiary university hospital in Barcelona (Catalonia, Spain) from 2014 to 2017. Study design: Specimens were collected from paediatric (< 17 years old) cases with suspicion of respiratory tract infection or EV infection. EV laboratory-confirmation was performed by specific real-time multiplex RT-PCR assay. Partial viral VP1 protein was sequenced for genetic characterisation by phylogenetic analyses. Results: A total of 376 (7%) from 5703 cases were EV laboratory-confirmed. Phylogenetic analyses of VP1 (210; 81%) sequences distinguished up to 27 different EV types distributed within EV-A (82; 40%), EV-B (90; 42%), EV-C (5; 2%), and EV-D (33; 15%), in addition to 50 (19%) rhinoviruses. The most predominant were EV-A71 (37; 45%) and EV-D68 (32; 99%). EV-A71 was highly related to neurological complications (25/39, 63%), of which 20/39 were rhombencephalitis, and most EV-D68 (28/32, 88%) were associated with lower respiratory tract infections (LRTI), and exceptionally one (3%) with acute flaccid paralysis. Conclusions: EV-A71 and EV-D68 were the most detected EV in respiratory specimens. EV-A71 was highly related to neurological disease and EV-D68 was often associated with LRTI. However, both potential relatedness to neurological diseases makes the monitoring of EV circulation obligatory.

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Enterovirus D68 Reemerges Globally as a Severe Pathogen Targeting Children*

Randolph¹

2016

Pediatric Critical Care Medicine

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Enterovirus D-68 in Critically-Ill Children: A Comparison to Pandemic H1N1 Influenza

Cited by 8 publications

References 0 publications

2014 outbreak of enterovirus D68 in North America

2014 outbreak of enterovirus D68 in North America

Surveillance of enteroviruses from paediatric patients attended at a tertiary hospital in Catalonia from 2014 to 2017

Enterovirus D68 Reemerges Globally as a Severe Pathogen Targeting Children*

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