Resource Burden During the 2014 Enterovirus D68 Respiratory Disease Outbreak at Children’s Hospital Colorado

Messacar, Kevin; Hawkins, S.J.; Baker, Joyce; Pearce, Kelly; Tong, Suhong; Dominguez, Samuel R.; Parker, Sarah K.

doi:10.1001/jamapediatrics.2015.3879

Cited by 18 publications

(16 citation statements)

References 3 publications

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“…The unprecedented surge in EV-D68 respiratory disease at our institution during 2014 (6) and uncertainty about its epidemiology prompted active surveillance for EV-D68 in 2015–2016. The complete absence of EV-D68 in 2015 and its resurgence in 2016 is suggestive of continued periodic circulation, similar to patterns being reported in Europe (14).…”

Section: Discussionmentioning

confidence: 99%

“…Between 2008 and 2014, an increasing number of small clusters of EV-D68 respiratory disease was reported in the USA, Europe, Africa, and southeast Asia (3, 4). In late summer and early fall of 2014, however, the largest reported outbreak of EV-D68-associated severe respiratory disease occurred in the USA and Canada (5, 6). Importantly, circulation of EV-D68 in 2014 coincided with an outbreak of acute flaccid myelitis (AFM) (7, 8), with accumulating evidence suggesting a causal link between EV-D68 and AFM (9).…”

Section: Introductionmentioning

confidence: 99%

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Surveillance for enterovirus D68 in colorado children reveals continued circulation

Messacar

Robinson

Pretty

et al. 2017

Journal of Clinical Virology

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Background The largest, most widespread outbreak of enterovirus D68 respiratory disease occurred from August to December of 2014 in the United States with 1,153 confirmed infections in 49 states. The epidemiology of enterovirus D68 following the 2014 outbreak is unknown. Objectives This study seeks to describe the epidemiology of enterovirus D68 circulation amongst Colorado children from 2014–2016. Study Design This is a prospective observational surveillance study of enterovirus D68 infection amongst children tested for respiratory pathogens from July–October 2014–2016 at Children’s Hospital Colorado (CHCO), a quaternary care children’s hospital in Aurora, CO. Results Amongst rhinovirus/enterovirus positive respiratory specimens from intensive care unit patients, ninety-eight of 314 (31.2%) in 2014, none of 307 (0%) specimens in 2015, and 19 of 240 (7.9%) specimens in 2016 were identified as enterovirus D68. Amongst respiratory specimens from all patients during the prospective active surveillance period, none of 1469 (0%) in 2015 and 46 of 1403 (3.3%) were positive for enterovirus D68. Conclusions Surveillance for enterovirus D68 amongst respiratory specimens at a quaternary care children’s hospital revealed a seasonal pattern of circulation in the late summer to early fall of 2014 and 2016. Continued surveillance of respiratory specimens is necessary to define the circulation pattern and understand the epidemiology of this emerging pathogen.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surveillance for enterovirus D68 in colorado children reveals continued circulation

Messacar

Robinson

Pretty

et al. 2017

Journal of Clinical Virology

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“…These findings have implications for epidemic planning. In particular, planning for an increased patient census in pediatric wards and ICUs, and increased demand for asthma therapeutics and respiratory equipment, may be important [6, 26, 39]. …”

Section: Discussionmentioning

confidence: 99%

“…From mid-August 2014 through 15 January 2015, a total of 1153 EV-D68 cases were confirmed in 49 US states and the District of Columbia [5]. Children were predominantly affected, and the epidemic resulted in a substantial resource burden at certain hospitals and emergency departments [6, 7]. …”

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confidence: 99%

Enterovirus D68 Infection Among Children With Medically Attended Acute Respiratory Illness, Cincinnati, Ohio, July–October 2014

Biggs

McNeal

Nix

et al. 2017

Clinical Infectious Diseases

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Background Enterovirus D68 (EV-D68) caused a widespread outbreak of respiratory illness in the United States in 2014, predominantly affecting children. We describe EV-D68 rates, spectrum of illness, and risk factors from prospective, population-based acute respiratory illness (ARI) surveillance at a large US pediatric hospital. Methods Children <13 years of age with ARI and residence in Hamilton County, Ohio were enrolled from the inpatient and emergency department (ED) settings at a children’s hospital in Cincinnati, Ohio, from 1 July to 31 October 2014. For each participant, we interviewed parents, reviewed medical records, and tested nasal and throat swabs for EV-D68 using real-time reverse-transcription polymerase chain reaction assay. Results EV-D68 infection was detected in 51 of 207 (25%) inpatients and 58 of 505 (11%) ED patients. Rates of EV-D68 hospitalization and ED visit were 1.3 (95% confidence interval [CI], 1.0–1.6) and 8.4 per 1000 children <13 years of age, respectively. Preexisting asthma was associated with EV-D68 infection (adjusted odds ratio, 3.2; 95% CI, 2.0–5.1). Compared with other ARI, children with EV-D68 were more likely to be admitted from the ED (P ≤ .001), receive supplemental oxygen (P = .001), and require intensive care unit admission (P = .04); however, mechanical ventilation was uncommon (2/51 inpatients; P = .64), and no deaths occurred. Conclusions During the 2014 EV-D68 epidemic, high rates of pediatric hospitalizations and ED visits were observed. Children with asthma were at increased risk for medically attended EV-D68 illness. Preparedness planning for a high-activity EV-D68 season in the United States should take into account increased healthcare utilization, particularly among children with asthma, during the late summer and early fall.

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“…The Colorado AFM cluster occurred during an outbreak of EV-D68 respiratory disease ( 3 ). During this period, CHCO emergency department visits and admissions for respiratory complaints to the hospital increased over prior years ( 11 ); EV-D68 detection among hospitalized patients subsequently increased ( 7 ). Although no etiology for the neurologic disease was identified among the Colorado cluster of patients (despite extensive testing, including metagenomic sequencing of cerebrospinal fluid), EV-D68 was found in the nasopharynx of 45% of these patients ( 7 , 12 ).…”

mentioning

confidence: 99%

Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014

Aliabadi¹,

Messacar

Pastula

et al. 2016

Emerg. Infect. Dis.

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Resource Burden During the 2014 Enterovirus D68 Respiratory Disease Outbreak at Children’s Hospital Colorado

Cited by 18 publications

References 3 publications

Surveillance for enterovirus D68 in colorado children reveals continued circulation

Surveillance for enterovirus D68 in colorado children reveals continued circulation

Enterovirus D68 Infection Among Children With Medically Attended Acute Respiratory Illness, Cincinnati, Ohio, July–October 2014

Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014

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