title: Systematic community- and hospital-based surveillance for enterovirus-D68 in three Canadian provinces, August to December 2014.
abstract: Respiratory specimens collected from outpatients with influenza-like illness in three Canadian provinces (British Columbia (BC), Alberta and Quebec) participating in a community-based sentinel surveillance network were prospectively screened for enterovirus-D68 (EV-D68) from 1 August to 31 December 2014 and compared to specimens collected from 1 October 2013 to 31 July 2014. Eighteen (1%) of 1,894 specimens were EV-D68-positive: 1/348 (0.3%) collected from October to December 2013 and 11/460 (2.4%) from October to December 2014, an eight-fold increase in detection rates (p=0.01), consistent with epidemic circulation in autumn 2014. The remaining EV-D68 detections were in September 2014 (6/37). Enhanced passive surveillance was also conducted on all inpatient and outpatient EV-D68 cases (n=211) detected at the BC provincial reference laboratory from 28 August to 31 December 2014. Incidence of hospitalisations was 3/100,000 overall and 21, 17, 4 and 1/100,000 among those<5, 5-9, 10-19 and ≥20-years-old with male-to-female ratios>1 among paediatric but not adult cases. Three cases in BC with comorbidity or co-infection died and five exhibited neurological features persisting >9 months. Active surveillance in outpatient and inpatient settings is needed from more areas and additional seasons to better understand EV-D68 epidemiology and potential at-risk groups for severe or unusual manifestations.
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Danuta M
authors.initials: DM
authors.lastname: Skowronski
authors.forename: Catharine
authors.initials: C
authors.lastname: Chambers
authors.forename: Suzana
authors.initials: S
authors.lastname: Sabaiduc
authors.forename: Michelle
authors.initials: M
authors.lastname: Murti
authors.forename: Reka
authors.initials: R
authors.lastname: Gustafson
authors.forename: Sue
authors.initials: S
authors.lastname: Pollock
authors.forename: Dee
authors.initials: D
authors.lastname: Hoyano
authors.forename: Shirley
authors.initials: S
authors.lastname: Rempel
authors.forename: Sandra
authors.initials: S
authors.lastname: Allison
authors.forename: Gaston
authors.initials: G
authors.lastname: De Serres
authors.forename: James A
authors.initials: JA
authors.lastname: Dickinson
authors.forename: Raymond
authors.initials: R
authors.lastname: Tellier
authors.forename: Kevin
authors.initials: K
authors.lastname: Fonseca
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Drews
authors.forename: Christine
authors.initials: C
authors.lastname: Martineau
authors.forename: Francesca
authors.initials: F
authors.lastname: Reyes-Domingo
authors.forename: Tom
authors.initials: T
authors.lastname: Wong
authors.forename: Patrick
authors.initials: P
authors.lastname: Tang
authors.forename: Mel
authors.initials: M
authors.lastname: Krajden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D004196:Disease Outbreaks; D030016:Enterovirus D, Human / Q000235:genetics / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007755:Laboratories, Hospital; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D011446:Prospective Studies; D012111:Residence Characteristics; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D012621:Seasons; D018571:Sentinel Surveillance; D017422:Sequence Analysis, DNA; D055815:Young Adult
keywords: Enterovirus; acute flaccid paralysis; enhanced surveillance; enterovirus D68; sentinel surveillance