title: Severe respiratory illness associated with enterovirus D68 - Missouri and Illinois, 2014.
abstract: On August 19, 2014, CDC was notified by Children's Mercy Hospital in Kansas City, Missouri, of an increase (relative to the same period in previous years) in patients examined and hospitalized with severe respiratory illness, including some admitted to the pediatric intensive care unit. An increase also was noted in detections of rhinovirus/enterovirus by a multiplex polymerase chain reaction assay in nasopharyngeal specimens obtained during August 5-19. On August 23, CDC was notified by the University of Chicago Medicine Comer Children's Hospital in Illinois of an increase in patients similar to those seen in Kansas City. To further characterize these two geographically distinct observations, nasopharyngeal specimens from most of the patients with recent onset of severe symptoms from both facilities were sequenced by the CDC Picornavirus Laboratory. Enterovirus D68 (EV-D68) was identified in 19 of 22 specimens from Kansas City and in 11 of 14 specimens from Chicago. Since these initial reports, admissions for severe respiratory illness have continued at both facilities at rates higher than expected for this time of year. Investigations into suspected clusters in other jurisdictions are ongoing.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Midgley
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Jackson
authors.forename: Rangaraj
authors.initials: R
authors.lastname: Selvarangan
authors.forename: George
authors.initials: G
authors.lastname: Turabelidze
authors.forename: Emily
authors.initials: E
authors.lastname: Obringer
authors.forename: Daniel
authors.initials: D
authors.lastname: Johnson
authors.forename: B Louise
authors.initials: BL
authors.lastname: Giles
authors.forename: Ajanta
authors.initials: A
authors.lastname: Patel
authors.forename: Fredrick
authors.initials: F
authors.lastname: Echols
authors.forename: M Steven
authors.initials: MS
authors.lastname: Oberste
authors.forename: W Allan
authors.initials: WA
authors.lastname: Nix
authors.forename: John T
authors.initials: JT
authors.lastname: Watson
authors.forename: Susan I
authors.initials: SI
authors.lastname: Gerber
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D030016:Enterovirus D, Human / Q000145:classification / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007087:Illinois; D007223:Infant; D008297:Male; D008923:Missouri; D012141:Respiratory Tract Infections / Q000821:virology*; D012720:Severity of Illness Index