Enterovirus D68 detection in respiratory specimens: Association with severe disease.
Molecular techniques increased the number of documented respiratory infections. In a substantial number of cases the causative agent remains undetected. Since August 2014, an increase in Enterovirus(EV)-D68 infections was reported. We aimed to investigate epidemiology and clinical relevance of EV-D68. From June to December 2014 and from September to December 2015, 803 and 847 respiratory specimens, respectively, were tested for respiratory viruses with a multiplex RT-PCR. This multiplex RT-PCR does not detect EV-D68. Therefore, 457 (2014) and 343 (2015) specimens with negative results were submitted to an EV-specific-RT-PCR. EV-positive specimens were tested with an EV-D68-specific-RT-PCR and genotyped. Eleven specimens of 2014 tested positive in the EV-specific-RT-PCR and of these seven were positive in the EV-D68-specific-RT-PCR. Typing confirmed these as EV-D68. Median age of EV-D68-positive patients was 3 years (1 month-91 years). Common symptoms included fever (n = 6, 86%), respiratory distress (n = 5, 71%), and cough (n = 4, 57%). All EV-D68-positive patients were admitted to hospital, 4 (57%) were admitted to intensive care units and 6 (86%) received oxygen. One patient suffered from acute flaccid paralysis. Seven specimens of 2015 were positive in the EV-specific-RT-PCR but negative in the EV-D68-specific-RT-PCR. In conclusion, use of an EV-specific-RT-PCR allowed us to detect EV-D68 circulation in autumn 2014 that was not detected by the multiplex RT-PCR and was associated with severe disease.
Univ Lille, Faculté de Médecine, CHU Lille, Laboratoire de Virologie EA3610, Lille, France.
Ilka
0000-0001-7489-3786
I
Engelmann
Univ Lille, Faculté de Médecine, CHU Lille, Laboratoire de Virologie EA3610, Lille, France.
Marie
M
Fatoux
Univ Lille, Faculté de Médecine, CHU Lille, Laboratoire de Virologie EA3610, Lille, France.
Mouna
M
Lazrek
Univ Lille, Faculté de Médecine, CHU Lille, Laboratoire de Virologie EA3610, Lille, France.
Enagnon K
EK
Alidjinou
CHU Clermont-Ferrand, Laboratoire de Virologie, Centre National de Référence des Entérovirus et Parechovirus, Laboratoire associé, Clermont-Ferrand Cedex, France.
Audrey
A
Mirand
CHU Clermont-Ferrand, Laboratoire de Virologie, Centre National de Référence des Entérovirus et Parechovirus, Laboratoire associé, Clermont-Ferrand Cedex, France.
Cécile
C
Henquell
Univ Lille, Faculté de Médecine, CHU Lille, Laboratoire de Virologie EA3610, Lille, France.
Anny
A
Dewilde
Univ Lille, Faculté de Médecine, CHU Lille, Laboratoire de Virologie EA3610, Lille, France.
Didier
D
Hober
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018893:Bronchoalveolar Lavage; D002648:Child; D002675:Child, Preschool; D003371:Cough; D004196:Disease Outbreaks; D030016:Enterovirus D, Human / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology*; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008168:Lung / Q000821:virology; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D010243:Paralysis / Q000209:etiology / Q000821:virology; D060888:Real-Time Polymerase Chain Reaction; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology*; D012720:Severity of Illness Index; D055815:Young Adult
acute flaccid paralysis; human enterovirus 68; myelitis; respiratory tract infection; sequencing