Clinical Course of Enterovirus D68 in Hospitalized Children.

Creator(s)

Jennifer E. Schuster, Children's Mercy HospitalFollow
Rangaraj Selvarangan, Children's Mercy HospitalFollow
Ferdaus Hassan
Kayla B. Briggs
Lindsay Hays
Jenna Miller, Children's Mercy HospitalFollow
Barbara A. Pahud, Children's Mercy HospitalFollow
Henry T. Puls, Children's Mercy HospitalFollow
Mary Ann Queen, Children's Mercy HospitalFollow
Marita Thompson, Children's Mercy HospitalFollow
Gina Weddle, Children's Mercy HospitalFollow
Mary Anne Jackson, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

3-1-2017

Identifier

DOI: 10.1097/INF.0000000000001421

Abstract

BACKGROUND: Enterovirus D68 (EV-D68) has been sporadically reported as a cause of respiratory tract infections. In 2014, an international outbreak of EV-D68 occurred and caused severe respiratory disease in the pediatric population.

METHODS: A retrospective chart review was performed of children admitted to Children's Mercy Hospital from August 1, 2014, to September 15, 2014, with positive multiplex polymerase chain reaction testing for EV/rhinovirus (RV). Specimens were subsequently tested for EV-D68, and clinical data were obtained from the medical records. Patients with EV-D68 were compared with children presenting simultaneously with other EV/RV.

RESULTS: Of 542 eligible specimens, children with EV-D68 were significantly older than children with other EV/RV (4.6 vs. 2.2 years, P < 0.001). Children with EV-D68 were more likely to have a history of asthma (38.6% vs. 30.0%, P = 0.04) or recurrent wheezing (22.1% vs. 14.8%, P = 0.04). EV-D68-positive children more commonly received supplemental oxygen (86.7% vs. 65.0%, P < 0.001), albuterol (91.2% vs. 65.5%, P < 0.001) and corticosteroids (82.9% vs. 58.6%, P < 0.001). Age ≥5 years was an independent risk factor for intensive care unit management in EV-D68-infected children. Children with a history of asthma or recurrent wheezing and EV-D68 received supplemental oxygen (92.7% vs. 82.4%, P = 0.007) and magnesium (42.7% vs. 29.7%, P = 0.03) at higher rates and more continuous albuterol (3 vs. 2 hours, P = 0.03) than those with other EV/RV.

CONCLUSIONS: EV-D68 causes severe disease in the pediatric population, particularly in children with a history of asthma or recurrent wheezing. EV-D68-positive children are more likely to require therapy for refractory bronchospasm and may need intensive care unit- level care.

Journal Title

The Pediatric infectious disease journal

Volume

36

Issue

3

First Page

290

Last Page

295

MeSH Keywords

Child; Child, Preschool; Disease Outbreaks; Enterovirus D, Human; Enterovirus Infections; Female; Hospitalization; Humans; Male; Retrospective Studies

Recommended Citation

Schuster JE, Selvarangan R, Hassan F, et al. Clinical Course of Enterovirus D68 in Hospitalized Children. Pediatr Infect Dis J. 2017;36(3):290-295. doi:10.1097/INF.0000000000001421