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The Emergence of Enterovirus-D68

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  • Authors: Kevin Messacar1, Mark J. Abzug3, Samuel R. Dominguez4
  • Editors: W. Michael Scheld5, James M. Hughes6, Richard J. Whitley7
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: University of Colorado School of Medicine, Department of Pediatrics, Section of Infectious Disease; 2: Section of Hospital Medicine, Aurora, CO 80045; 3: University of Colorado School of Medicine, Department of Pediatrics, Section of Infectious Disease; 4: University of Colorado School of Medicine, Department of Pediatrics, Section of Infectious Disease; 5: Department of Infectious Diseases, University of Virginia Health System, Charlottesville, VA; 6: Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA; 7: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
  • Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.EI10-0018-2016
  • Received 18 February 2016 Accepted 18 February 2016 Published 10 June 2016
  • Samuel R. Dominguez, samuel.dominguez@childrenscolorado.org
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  • Abstract:

    Enterovirus-D68 (EV-D68) is a unique enterovirus, similar to human rhinoviruses, spread via the respiratory route and primarily causing respiratory disease. Increasing clusters of EV-D68 associated respiratory disease have been reported since 2008, with the largest reported outbreak occurring in North America in 2014. Epidemiologic data and biological plausibility support an association of EV-D68 with the neurologic condition, acute flaccid myelitis. Diagnosis requires EV-D68 specific PCR or viral sequencing of respiratory specimens. Treatment consists of supportive care, as there are no currently available effective vaccines or antiviral therapies. Further research is needed to prepare for future EV-D68 outbreaks of respiratory or neurologic disease.

  • Citation: Messacar K, Abzug M, Dominguez S. 2016. The Emergence of Enterovirus-D68. Microbiol Spectrum 4(3):EI10-0018-2016. doi:10.1128/microbiolspec.EI10-0018-2016.

Key Concept Ranking

Upper Respiratory Tract Infections
0.8888743
Lower Respiratory Tract Infections
0.8184478
Respiratory Diseases
0.5711135
Infectious Diseases
0.49578747
Single-Stranded RNA Viruses
0.49036425
Acute Flaccid Paralysis
0.45527714
0.8888743

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/content/journal/microbiolspec/10.1128/microbiolspec.EI10-0018-2016
2016-06-10
2017-05-28

Abstract:

Enterovirus-D68 (EV-D68) is a unique enterovirus, similar to human rhinoviruses, spread via the respiratory route and primarily causing respiratory disease. Increasing clusters of EV-D68 associated respiratory disease have been reported since 2008, with the largest reported outbreak occurring in North America in 2014. Epidemiologic data and biological plausibility support an association of EV-D68 with the neurologic condition, acute flaccid myelitis. Diagnosis requires EV-D68 specific PCR or viral sequencing of respiratory specimens. Treatment consists of supportive care, as there are no currently available effective vaccines or antiviral therapies. Further research is needed to prepare for future EV-D68 outbreaks of respiratory or neurologic disease.

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Figures

Image of FIGURE 1
FIGURE 1

Analysis of 606 EV-D68 VP1 sequences from the U.S. outbreak, August to November 2014. Neighbor-joining analysis (MEGA 6.0). Comparison of U.S. 2014 EV-D68 strains with other 2014 strains identified internationally and with EV-D68 strains circulating prior to 2014. Neighbor-joining tree (MEGA 6). Pink shading indicates EV-D68 strains circulating prior to 2014. Red circles indicate strains of EV-D68 identified in respiratory specimens from patients who developed AFM. From Molecular epidemiology of Enterovirus-D68 associated with a nationwide outbreak of severe respiratory illness, United States, 2014. Abstract, 31st Clinical Virology Symposium, 2015, Daytona Beach, FL. Used with permission from the authors at the CDC.

Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.EI10-0018-2016
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Image of FIGURE 2
FIGURE 2

Number of visits for respiratory illness to the Children’s Hospital Colorado emergency department requiring hospital admission and the cases of acute flaccid myelitis during the 2014 EV-D68 outbreak. Visits with a chief complaint of respiratory symptoms requiring hospital admission from the week ending 2 August 2014 (week 31) to that ending 25 October 2014 (week 43) compared with the same timeframe for 2012–2013 and the timing of the cases of acute flaccid myelitis. Reprinted from reference 60 , with permission.

Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.EI10-0018-2016
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Tables

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TABLE 1

Enterovirus-D68 respiratory disease: highlights of clinical presentation, diagnosis, and management from the 2014 North American outbreak

Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.EI10-0018-2016
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TABLE 2

Acute flaccid myelitis potentially associated with enterovirus-D68: highlights of clinical presentation, diagnosis, and management from the 2014 North American outbreak

Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.EI10-0018-2016

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