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Publication Date

5-2023

Abstract

Background: In 2014, the largest cohort of pediatric EV-D68 disease in the U.S. was reported by a large mid-west free-standing children’s hospital. Shortly after, reports of increased EV-D68 around the world were announced. Since then, EV-D68 has circulated even years during the summer to fall months. In June 2022, an increase in Rhinovirus/Enterovirus (RV/EV) infections with symptoms resembling EV-D68 outbreaks were noted earlier than usual in Kansas City’s clinical setting. Common symptoms of EV-D68 infection resemble asthma and severe EV-D68 infection has been linked to those with a history of asthma. Our aim was to investigate the rate of EV-D68 infections in children enrolled in the Center of Disease Control and Prevention (CDC)’s New Vaccine Surveillance Network (NVSN) acute respiratory infections (ARI) study.

Methods: Between January-December 2022, children < 18 years old seen at the hospital with symptoms of respiratory infection were enrolled into the CDC’s NVSN ARI study. Nasal samples collected in universal transport media were tested by NxTAG® Respiratory Pathogen Panel (Luminex) multiplex assay that can simultaneously detect 20 respiratory pathogens. Those with RV/EV detections were further tested by a real-time EV-D68 RT-PCR. Demographic and clinical information were also collected throughout the season.

Results: A total of 2,514 samples were tested; RV/EV was detected in 27% (n=690). EV-D68 was detected in 13.5% (n=93/690) of positive RV/EV samples, with an overall 3.7% (n=93/2514) rate of EV-D68 detection. EV-D68 was found highest in Black/African Americans (50%); in children ages 1-4 years (66%) and in males (57%). EV-D68 was more prevalent in subjects enrolled in the emergency department setting (57%) compared to the inpatient (30%) and clinic settings (13%). The most common symptoms reported by subjects and their families were coughing (97%), nasal congestion (90%), and rapid shallow breathing (77%). All 93 EV-D68 positives were detected in the summer to fall months (June to September).

Conclusions: The detection of EV-D68 within the CDC’s surveillance network brought an early awareness to the symptoms and diagnosis of this illness. These findings were reported to the CDC and in September 2022, a health advisory stating the increase in EV-D68 prevalence in hospitals and clinics nationwide was reported. Data gathered and presented here can contribute to early detection and preparedness for future outbreaks.

Document Type

Poster

Detection of Enterovirus D68 in Samples Enrolled in the New Vaccine Surveillance Network from January to December 2022

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