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Severe Respiratory Illness Associated With Rhinovirus During the Enterovirus D68 Outbreak in the United States, August 2014-November 2014.
Clin Infect Dis. 2018 05 02; 66(10):1528-1534.CI

Abstract

Background

In 2014, a nationwide outbreak of severe respiratory illness occurred in the United States, primarily associated with enterovirus D68 (EV-D68). A proportion of illness was associated with rhinoviruses (RVs) and other enteroviruses (EVs), which we aimed to characterize further.

Methods

Respiratory specimens from pediatric and adult patients with respiratory illness were submitted to the Centers for Disease Control and Prevention during August 2014-November 2014. While initial laboratory testing focused on identification of EV-D68, the negative specimens were typed by molecular sequencing to identify additional EV and RV types. Testing for other pathogens was not conducted. We compared available clinical and epidemiologic characteristics among patients with EV-D68 and RV species A-C identified.

Results

Among 2629 typed specimens, 1012 were EV-D68 (39%) and 81 (3.1%) represented 24 other EV types; 968 were RVs (37%) covering 114 types and grouped into 3 human RV species (RV-A, 446; RV-B, 133; RV-C, 389); and 568 (22%) had no RV or EV detected. EV-D68 was more frequently identified in patients who presented earlier in the investigation period. Among patients with EV-D68, RV-A, RV-B, or RV-C, the age distributions markedly differed. Clinical syndromes and intensive care unit admissions by age were largely similar.

Conclusions

RVs were commonly associated with severe respiratory illness during a nationwide outbreak of EV-D68, and most clinical. Characteristics were similar between groups. A better understanding of the epidemiology of RVs and EVs is needed to help inform development and use of diagnostic tests, therapeutics, and preventive measures.

Authors+Show Affiliations

Division of Viral Diseases, Centers for Disease Control and Prevention Atlanta, Georgia.MAXIMUS Federal, contracting agency to the Division of Viral Diseases, Centers for Disease Control and Prevention Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention Atlanta, Georgia.Battelle, Columbus, Ohio.Division of Viral Diseases, Centers for Disease Control and Prevention Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention Atlanta, Georgia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29186347

Citation

Prill, Mila M., et al. "Severe Respiratory Illness Associated With Rhinovirus During the Enterovirus D68 Outbreak in the United States, August 2014-November 2014." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 66, no. 10, 2018, pp. 1528-1534.
Prill MM, Dahl RM, Midgley CM, et al. Severe Respiratory Illness Associated With Rhinovirus During the Enterovirus D68 Outbreak in the United States, August 2014-November 2014. Clin Infect Dis. 2018;66(10):1528-1534.
Prill, M. M., Dahl, R. M., Midgley, C. M., Chern, S. W., Lu, X., Feikin, D. R., Sakthivel, S. K., Nix, W. A., Watson, J. T., Gerber, S. I., & Oberste, M. S. (2018). Severe Respiratory Illness Associated With Rhinovirus During the Enterovirus D68 Outbreak in the United States, August 2014-November 2014. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 66(10), 1528-1534. https://doi.org/10.1093/cid/cix1034
Prill MM, et al. Severe Respiratory Illness Associated With Rhinovirus During the Enterovirus D68 Outbreak in the United States, August 2014-November 2014. Clin Infect Dis. 2018 05 2;66(10):1528-1534. PubMed PMID: 29186347.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Severe Respiratory Illness Associated With Rhinovirus During the Enterovirus D68 Outbreak in the United States, August 2014-November 2014. AU - Prill,Mila M, AU - Dahl,Rebecca M, AU - Midgley,Claire M, AU - Chern,Shur-Wern Wang, AU - Lu,Xiaoyan, AU - Feikin,Daniel R, AU - Sakthivel,Senthilkumar K, AU - Nix,W Allan, AU - Watson,John T, AU - Gerber,Susan I, AU - Oberste,M Steven, PY - 2017/09/12/received PY - 2017/11/20/accepted PY - 2017/12/1/pubmed PY - 2019/10/12/medline PY - 2017/11/30/entrez SP - 1528 EP - 1534 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 66 IS - 10 N2 - Background: In 2014, a nationwide outbreak of severe respiratory illness occurred in the United States, primarily associated with enterovirus D68 (EV-D68). A proportion of illness was associated with rhinoviruses (RVs) and other enteroviruses (EVs), which we aimed to characterize further. Methods: Respiratory specimens from pediatric and adult patients with respiratory illness were submitted to the Centers for Disease Control and Prevention during August 2014-November 2014. While initial laboratory testing focused on identification of EV-D68, the negative specimens were typed by molecular sequencing to identify additional EV and RV types. Testing for other pathogens was not conducted. We compared available clinical and epidemiologic characteristics among patients with EV-D68 and RV species A-C identified. Results: Among 2629 typed specimens, 1012 were EV-D68 (39%) and 81 (3.1%) represented 24 other EV types; 968 were RVs (37%) covering 114 types and grouped into 3 human RV species (RV-A, 446; RV-B, 133; RV-C, 389); and 568 (22%) had no RV or EV detected. EV-D68 was more frequently identified in patients who presented earlier in the investigation period. Among patients with EV-D68, RV-A, RV-B, or RV-C, the age distributions markedly differed. Clinical syndromes and intensive care unit admissions by age were largely similar. Conclusions: RVs were commonly associated with severe respiratory illness during a nationwide outbreak of EV-D68, and most clinical. Characteristics were similar between groups. A better understanding of the epidemiology of RVs and EVs is needed to help inform development and use of diagnostic tests, therapeutics, and preventive measures. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/29186347/Severe_Respiratory_Illness_Associated_With_Rhinovirus_During_the_Enterovirus_D68_Outbreak_in_the_United_States_August_2014_November_2014_ DB - PRIME DP - Unbound Medicine ER -