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Enterovirus D68-Associated Respiratory Illness in Children
Benjamin R Clopper1, Adriana S Lopez1, Leah A Goldstein1
1US Centers for Disease Control and Prevention, Atlanta, Georgia.
JAMA Network Open
|May 8, 2025
Summary
Enterovirus D68 (EV-D68) causes severe respiratory illness in children, even those without underlying conditions. Comorbidities other than asthma or reactive airway disease increase hospitalization severity and intensive care needs.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Viral Infections
- Epidemiology
Background:
- Enterovirus D68 (EV-D68) is a significant cause of acute respiratory illness (ARI) in children, but US surveillance and understanding of its epidemiology and clinical severity are limited.
- Limited data exist on the specific risk factors and outcomes associated with EV-D68 infection in US children requiring medical care.
Purpose of the Study:
- To characterize the epidemiology and clinical severity of EV-D68 among US children seeking care for ARI.
- To identify factors associated with severe outcomes in hospitalized children with EV-D68 infection.
Main Methods:
- A cross-sectional study using data from the New Vaccine Surveillance Network (2017-2022) at 7 US academic medical centers.
- Active, prospective surveillance enrolled children younger than 18 years with ARI and laboratory-confirmed EV-D68 infection.
- Multivariable logistic regression analyzed factors associated with supplemental oxygen or intensive care admission in hospitalized children without viral codetection.
Main Results:
- 976 children with EV-D68 were identified; 536 required hospitalization.
- Among hospitalized children, 37.1% had asthma/RAD, and 14.4% had other underlying conditions.
- Non-asthma/RAD comorbidities were associated with increased odds of requiring supplemental oxygen (aOR, 2.72) or intensive care (aOR, 3.09).
Conclusions:
- EV-D68 is associated with severe disease in children, including those who are otherwise healthy.
- Children with comorbidities other than asthma or reactive airway disease face a higher risk of severe outcomes when hospitalized with EV-D68.
- Findings highlight the need for enhanced EV-D68 surveillance and clinical management strategies.
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