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Enterovirus D68 outbreak detection through a syndromic disease epidemiology network
Lindsay Meyers1, Jennifer Dien Bard2, Ben Galvin1
1BioFire Diagnostics, Salt Lake City, UT, 84103, United States.
Summary
A new model, Pathogen Extended Resolution (PER), can now detect enterovirus D68 (EV-D68) in clinical samples. This tool accurately predicted EV-D68 outbreaks and alerted healthcare providers, improving patient care during respiratory illness seasons.
Area of Science:
- Virology
- Epidemiology
- Clinical Diagnostics
Background:
- Enterovirus D68 (EV-D68) caused a significant pediatric respiratory illness outbreak in 2014, yet lacks a commercial diagnostic assay.
- The BioFire® Syndromic Trends (Trend) network collects real-time de-identified test results globally.
Purpose of the Study:
- To develop a model, Pathogen Extended Resolution (PER), to differentiate EV-D68 from other respiratory viruses using existing BioFire® Respiratory Panel (RP) data.
- To validate PER's ability to monitor EV-D68 outbreaks in near real-time.
Main Methods:
- PER was developed using real-time PCR metrics from RP assays, incorporating data from 1,619 samples across six institutions.
- The model was validated against EV-D68 gold-standard molecular methods and applied to over 600,000 historical Trend RP tests.
- PER was utilized as a prospective monitoring tool during the 2018 EV-D68 outbreak.
Main Results:
- The PER algorithm achieved 87.1% sensitivity and 86.1% specificity in distinguishing EV-D68.
- PER successfully provided early alerts for the 2018 EV-D68 outbreak, enabling timely institutional testing.
- Analysis of historical data revealed potential EV-D68 outbreaks in 2014, 2016, and 2018, with regional rates up to 37%.
Conclusions:
- The PER model, integrated with the Trend network, accurately predicts EV-D68 outbreaks.
- PER provides timely notifications to clinical laboratories regarding EV-D68 circulation, enhancing public health surveillance.
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