title: Epidemiological and clinical characteristics of patients infected with enterovirus D68, France, July to December 2014.
abstract: In 2014, the United States (US) experienced a nationwide outbreak of enterovirus D68 (EV-D68) infection with 1,152 cases reported mainly in hospitalised children with severe asthma or bronchiolitis. Following the US alert, 11 laboratories of the French enterovirus (EV) surveillance network participated in an EV-D68 survey. A total of 6,229 respiratory samples, collected from 1 July to 31 December 2014, were screened for EV-D68 resulting in 212 EV-D68-positive samples. These 212 samples corresponded to 200 EV-D68 cases. The overall EV-D68 positivity rates among respiratory samples were of 5% (184/3,645) and 1.1% (28/2,584) in hospitalised children and adults respectively. The maximum weekly EV-D68 positivity rates were of 16.1% for children (n = 24/149; week 43) and 2.6% for adults (n = 3/115; week 42). Of 173 children with EV-D68 infection alone, the main symptoms were asthma (n = 83; 48.0%) and bronchiolitis (n = 37; 21.4%). One child developed acute flaccid paralysis (AFP) following EV-D68-associated pneumonia. Although there was no significant increase in severe respiratory tract infections reported to the French public health authorities, 10.7% (19/177) of the EV-D68 infected children and 14.3% (3/21) of the EV-D68 infected adults were hospitalised in intensive care units. Phylogenetic analysis of the viral protein 1 (VP1) sequences of 179 EV-D68 cases, revealed that 117 sequences (65.4%), including that of the case of AFP, belonged to the B2 variant of clade B viruses. Continuous surveillance of EV-D68 infections is warranted and could benefit from existing influenza-like illness and EV surveillance networks.
authors.affiliation: Centre National de Référence des Enterovirus et Parechovirus, Laboratoire de Virologie, Hospices Civils de Lyon, Lyon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Schuffenecker
authors.forename: Audrey
authors.initials: A
authors.lastname: Mirand
authors.forename: Laurence
authors.initials: L
authors.lastname: Josset
authors.forename: Cécile
authors.initials: C
authors.lastname: Henquell
authors.forename: Denise
authors.initials: D
authors.lastname: Hecquet
authors.forename: Léa
authors.initials: L
authors.lastname: Pilorgé
authors.forename: Joëlle
authors.initials: J
authors.lastname: Petitjean-Lecherbonnier
authors.forename: Catherine
authors.initials: C
authors.lastname: Manoha
authors.forename: Jérôme
authors.initials: J
authors.lastname: Legoff
authors.forename: Claire
authors.initials: C
authors.lastname: Deback
authors.forename: Sylvie
authors.initials: S
authors.lastname: Pillet
authors.forename: Quentin
authors.initials: Q
authors.lastname: Lepiller
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Mansuy
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Marque-Juillet
authors.forename: Denise
authors.initials: D
authors.lastname: Antona
authors.forename: Hélène
authors.initials: H
authors.lastname: Peigue-Lafeuille
authors.forename: Bruno
authors.initials: B
authors.lastname: Lina
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D030016:Enterovirus D, Human / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D055815:Young Adult
keywords: Acute flaccid paralysis; Asthma; Bronchiolitis; Enterovirus D68; France; Surveillance