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Clinical Characterization of Children Presenting to the Hospital with Enterovirus D68 Infection During the 2014

Anthony Orvedahl1, Amruta Padhye, Kevin Barton

  • 1From the *Department of Pediatrics and †Division of Biostatistics, Washington University School of Medicine, St. Louis, MO; and ‡St. Louis Children's Hospital, St. Louis, MO.

The Pediatric Infectious Disease Journal
|January 16, 2016
PubMed

Insights

Enterovirus D68 (EV-D68) caused a large 2014 outbreak, increasing hospitalizations. However, EV-D68 infections did not show increased severity compared to other enteroviruses, indicating the impact was due to higher case numbers.

Area of Science:

  • Pediatric Infectious Diseases
  • Virology
  • Epidemiology

Background:

  • The 2014 enterovirus D68 (EV-D68) outbreak represented a significant public health event.
  • Characterizing EV-D68's clinical impact is crucial for understanding its epidemiology.

Purpose of the Study:

  • To compare the illness severity and clinical presentation of children infected with EV-D68 versus non-EV-D68 human rhinoviruses/enteroviruses (HRV/EV).

Main Methods:

  • Retrospective analysis of pediatric patients at St. Louis Children's Hospital (August-October 2014).
  • Comparison of EV-D68 positive cases with age and severity-matched non-EV-D68 HRV/EV cases.
  • Evaluation of severity, length of stay, and hospital charges.

Main Results:

  • A notable increase in hospital census coincided with the EV-D68 outbreak.
  • No significant differences were observed in illness severity, length of stay, or charges between EV-D68 and non-EV-D68 groups.
  • EV-D68 cases commonly presented with respiratory distress (difficulty breathing, wheezing, tachypnea, retractions).
  • Common treatments included albuterol and corticosteroids, with asthma exacerbation as the frequent discharge diagnosis.

Conclusions:

  • EV-D68 led to a substantial 2014 outbreak with increased hospital admissions and charges.
  • The impact of EV-D68 was primarily driven by the increased number of infected children presenting to the hospital, not by increased illness severity.
  • Findings suggest EV-D68 infections should be managed similarly to other HRV/EV infections in terms of severity assessment.
Abstract

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