Methods: All consecutive children with nasopharyngeal swabs tested positive for rhino/enterovirus were reflexed to EV-D68 testing between August 1 and October 31, 2014. We compared characteristics and outcome of EV-D68 to non EV-D68 cases in a nested case-control study.
Results: A total of 93/297 (31.3%) of rhino/enterovirus samples were EV-D68 positive. Comparing 87 matched pairs, we found that difficulty with breathing was more common in EV-D68 cases (odds ratio 3.00, 95% confidence interval 1.47-6.14, p=0.003). EV-D68 cases were also more likely to have a family history of atopy (2.25, 0.98-5.17, p=0.05) but less likely to have significant co-morbidities (0.59, 0.32-1.10, p=0.1). Admission to the hospital (2.33, 1.07-5.09, p=0.03) was more common with EV-D68, but the likelihood of admission to critical care or death were similar in univariable as well as multivariable analysis. There was no evidence for in-hospital transmission of EV-D68.
Conclusion: EV-D68 seems to be a more virulent pulmonary pathogen than non EV-D68 rhino/enteroviruses, especially to children with pre-existing atopic disease, however, there seems not be a significant difference in terms of need for critical care or death. How it compares to more established pathogens such as influenza is yet to be determined. Droplet/contact precautions for children presenting with respiratory symptoms was sufficient to prevent in-hospital transmissions.
J. Pernica, None
K. Luinstra, None
C. Rutherford, None
M. Smieja, None