EV-D68 infection in children with asthma exacerbation and pneumonia in Mexico City during 2014 autumn

Influenza Other Respir Viruses. 2016 May;10(3):154-60. doi: 10.1111/irv.12384.

Abstract

Background: Human enterovirus D68 (EV-D68) recently caused an increase in mild-to-severe pediatric respiratory cases in North America and some European countries. Even though few of these children presented with acute paralytic disease, direct causal relationship cannot yet be assumed.

Objectives: The purposes of this report were to describe the clinical findings of an outbreak of EV-D68 infection in Mexico City and identify the genetic relationship with previously reported strains.

Patients/methods: Between September and December 2014, 126 nasopharyngeal samples (NPS) of hospitalized children <15 years of age with ARI were tested for the presence of respiratory viruses using a multiplex RT-qPCR and EV-D68-specific RT-qPCR. Clinical, epidemiological, and demographic data were collected and associated with symptomatology and viral infections. Phylogenetic analyses were performed using VP1 region.

Results: Enterovirus/rhinovirus infection was detected in 40 patients (31·7%), of which 24 patients were EV-D68-positive. EV-D68 infection prevailed over September and October 2014 and was associated with neutrophilia and lymphopenia, and patients were more likely to develop hypoxemia. Phylogenetic analyses showed that Mexican EV-D68 belongs to the new B1 clade.

Conclusions: This is the first EV-D68 outbreak described in Mexico and occurred few weeks after the United States reported similar infections. Although EV-D68 belongs to new B1 clade, no neurological affection was observed.

Keywords: Enterovirus D68; epidemiology; outbreak; pediatric; respiratory viruses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Asia / epidemiology
  • Asthma / complications*
  • Asthma / epidemiology
  • Child
  • Child, Preschool
  • Disease Outbreaks
  • Disease Progression
  • Enterovirus D, Human / classification
  • Enterovirus D, Human / genetics
  • Enterovirus D, Human / isolation & purification*
  • Enterovirus Infections / epidemiology*
  • Enterovirus Infections / virology*
  • Europe / epidemiology
  • Female
  • Humans
  • Infant
  • Male
  • Mexico / epidemiology
  • Nasopharynx / virology
  • Phylogeny
  • Picornaviridae Infections / epidemiology
  • Picornaviridae Infections / virology
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / virology
  • Real-Time Polymerase Chain Reaction
  • Respiratory Tract Infections / complications
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / virology*
  • Rhinovirus / genetics
  • Rhinovirus / isolation & purification
  • Seasons
  • United States / epidemiology

Associated data

  • GENBANK/KR081323
  • GENBANK/KR081333
  • GENBANK/KT382190
  • GENBANK/KT382193