Surveillance for enterovirus D68 in colorado children reveals continued circulation

Abstract

Background: The largest, most widespread outbreak of enterovirus D68 respiratory disease occurred from August to December of 2014 in the United States with 1153 confirmed infections in 49 states. The epidemiology of enterovirus D68 following the 2014 outbreak is unknown.

Objectives: This study seeks to describe the epidemiology of enterovirus D68 circulation amongst Colorado children from 2014 to 2016.

Study design: This is a prospective observational surveillance study of enterovirus D68 infection amongst children tested for respiratory pathogens from July-October 2014-2016 at Children's Hospital Colorado (CHCO), a quaternary care children's hospital in Aurora, CO.

Results: Amongst rhinovirus/enterovirus positive respiratory specimens from intensive care unit patients, ninety-eight of 314 (31.2%) in 2014, none of 307 (0%) specimens in 2015, and 19 of 240 (7.9%) specimens in 2016 were identified as enterovirus D68. Amongst respiratory specimens from all patients during the prospective active surveillance period, none of 1469 (0%) in 2015 and 46 of 1403 (3.3%) were positive for enterovirus D68.

Conclusions: Surveillance for enterovirus D68 amongst respiratory specimens at a quaternary care children's hospital revealed a seasonal pattern of circulation in the late summer to early fall of 2014 and 2016. Continued surveillance of respiratory specimens is necessary to define the circulation pattern and understand the epidemiology of this emerging pathogen.

Keywords: Acute flaccid myelitis; Enterovirus; Enterovirus-D68; Respiratory disease; Surveillance.