Outbreak of Lower Respiratory Tract Illness Associated With Human Enterovirus 68 Among American Indian Children

Abstract

Human enterovirus 68 (EV68) infections are rarely reported. We describe a respiratory outbreak associated with EV68 among 18 children admitted to a remote Indian Health Service facility during August 11, 2010 through September 14, 2010. Clinical illness was characterized by pneumonia and wheezing. EV68 should be considered as an etiology in outbreaks of lower respiratory tract illness.

Enterovirus 68 in Pediatric Patients Hospitalized for Acute Airway Diseases

“…Unlike other enteroviruses, HEV-D68 is acid labile and biologically more similar to human rhinoviruses in being mainly associated with respiratory diseases; however, until recently, reports of respiratory infections due to HEV-D68 were rare (2,3). Over the past 3 years, outbreaks in Japan, the Philippines, and the Netherlands as well as epidemic clusters in the United Kingdom have implicated HEV-D68 as an emerging respiratory pathogen (2,(4)(5)(6)(7)(8)(9). The clinical presentation of HEV-D68 infections during these outbreaks ranged from mild illness to rare severe pneumonia cases requiring admission in intensive care units (2,(4)(5)(6)(7)(8)(9).…”

“…The clinical presentation of HEV-D68 infections during these outbreaks ranged from mild illness to rare severe pneumonia cases requiring admission in intensive care units (2,(4)(5)(6)(7)(8)(9). Among these epidemic strains, novel genetic variants were described (2,(4)(5)(6)(7)(8). The present classical enterovirus molecular assays used in routine virological diagnosis can fail to detect HEV-D68 strains in respiratory samples, leading to an underestimation of the prevalence and the role of HEV-D68 infections in pediatric acute airway diseases (10).…”

“…Over the past 3 years, outbreaks in Japan, the Philippines, and the Netherlands as well as epidemic clusters in the United Kingdom have implicated HEV-D68 as an emerging respiratory pathogen (2, 4-9). The clinical presentation of HEV-D68 infections during these outbreaks ranged from mild illness to rare severe pneumonia cases requiring admission in intensive care units (2,(4)(5)(6)(7)(8)(9). Among these epidemic strains, novel genetic variants were described (2, 4-8).…”

Surveillance summary of hospitalized pediatric enterovirus D68 cases in Canada, September 2014

“…Since 2008, several outbreaks of EV-D68 have been reported internationally, including in the Philippines (2008−2009) (6), Japan (2010) (7,8), the Netherlands (2010) (9,10), and the United States (2009−2010) (11,12). Reported illness ranged from mild symptoms associated with respiratory illness (fever, runny nose, sneezing, coughing, and body and muscle aches) to severe disease, primarily pneumonia and bronchiolitis, requiring intensive care (12).…”

Circulation of two Enterovirus C105 (EV-C105) lineages in Europe and Africa

“…Therefore, it is suggested that the spread of EV-C105 could be wider than previously hypothesized. In addition, the increase of HEV detection among patients with acute respiratory syndrome underscores the need to include an enterovirus-specific assay in the molecular diagnostic panel of respiratory viral infections in hospitalized patients (Jacobson et al, 2012;Xiang et al, 2012).…”