Title
Severe enterovirus 68 respiratory illness in children requiring intensive care management
Document Type
Article
Publication Date
9-2015
Identifier
DOI: 10.1016/j.jcv.2015.07.298
Abstract
Background: Enterovirus 68 (EV-D68) causes acute respiratory tract illness in epidemic cycles, most recently in Fall 2014, but clinical characteristics of severe disease are not well reported.
Objectives: Children with EV-D68 severe respiratory disease requiring pediatric intensive care unit (PICU) management were compared with children with severe respiratory disease from other enteroviruses/rhinoviruses.
Study design: A retrospective review was performed of all children admitted to Children's Mercy Hospital PICU from August 1-September 15, 2014 with positive PCR testing for enterovirus/rhinovirus. Specimens were subsequently tested for the presence of EV-D68. We evaluated baseline characteristics, symptomatology, lab values, therapeutics, and outcomes of children with EV-D68 viral infection compared with enterovirus/rhinovirus-positive, EV-D68-negative children.
Results: A total of 86 children with positive enterovirus/rhinovirus testing associated with respiratory symptoms were admitted to the PICU. Children with EV-D68 were older than their EV-D68-negative counterparts (7.1 vs. 3.5 years, P=. 0.01). They were more likely to have a history of asthma or recurrent wheeze (68% vs. 42%, P=. 0.03) and to present with cough (90% vs. 63%, P=. 0.009). EV-D68 children were significantly more likely to receive albuterol (95% vs. 79%, P=. 0.04), magnesium (75% vs. 42%, P=. 0.004), and aminophylline (25% vs. 4%, P=. 0.03). Other adjunctive medications used in EV-D68 children included corticosteroids, epinephrine, and heliox; 44% of EV-D68-positive children required non-invasive ventilatory support.
Conclusions: EV-D68 causes severe disease in the pediatric population, particularly in children with asthma and recurrent wheeze; children may require multiple adjunctive respiratory therapies.
Journal Title
Journal of Clinical Virology
Volume
70
First Page
77
Last Page
82
Keywords
Acute respiratory tract infection, Asthma, Enterovirus, EV-D68, Intensive care unit, Respiratory virus
Recommended Citation
Schuster JE, Miller JO, Selvarangan R, et al. Severe enterovirus 68 respiratory illness in children requiring intensive care management. J Clin Virol. 2015;70:77-82. doi:10.1016/j.jcv.2015.07.298
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