507. Clinical Severity of Enterovirus D68 as Compared to Other Rhinovirus or Enterovirus Genotypes: A Matched Cohort Study
Session: Poster Abstract Session: Respiratory Infections: Pediatric
Thursday, October 8, 2015
Room: Poster Hall
  • 507 EV-D68 ID Week 2015.pdf (53.3 kB)
  • Background: Enterovirus D68 (EV-D68) resulted in a perceived increase in the number of children needing hospital or critical care admission because of respiratory insufficiency. It remained unclear, however, whether EV-D68 infections were more severe than infections by non EV-D68 rhino/enterovirus infections.

    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.

    Dominik Mertz, MD, MSc1, Abdulsalam Alawfi, MD1, Jeffrey Pernica, MD, MSc, FRCPC2, Kathy Luinstra, BSc3, Candy Rutherford, MLT, ART4 and Marek Smieja, MD, PhD1, (1)McMaster University, Hamilton, ON, Canada, (2)Pediatrics, McMaster University, Hamilton, ON, Canada, (3)St. Joseph's Healthcare, Hamilton, ON, Canada, (4)Hamilton Regional Laboratory Medicine Program, Hamilton, ON, Canada


    D. Mertz, None

    A. Alawfi, None

    J. Pernica, None

    K. Luinstra, None

    C. Rutherford, None

    M. Smieja, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.