PT  - JOURNAL ARTICLE
AU  - Dominik Mertz
AU  - Abdulsalam Alawfi
AU  - Jeffrey M. Pernica
AU  - Candy Rutherford
AU  - Kathy Luinstra
AU  - Marek Smieja
TI  - Clinical severity of pediatric respiratory illness with enterovirus D68 compared with rhinovirus or other enterovirus genotypes
AID  - 10.1503/cmaj.150619
DP  - 2015 Nov 17
TA  - Canadian Medical Association Journal
PG  - 1279--1284
VI  - 187
IP  - 17
4099  - http://www.cmaj.ca/content/187/17/1279.short
4100  - http://www.cmaj.ca/content/187/17/1279.full
SO  - CMAJ2015 Nov 17; 187
AB  - Background: Enterovirus D68 (EV-D68) resulted in a reported increase in the number of children needing hospital or critical care admission because of respiratory insufficiency during 2014. It remains unclear, however, whether EV-D68 infections were more severe than rhinovirus or non–EV-D68 enterovirus infections.Methods: We evaluated consecutive children presenting to a pediatric hospital between Aug. 1 and Oct. 31, 2014, with positive nasopharyngeal swabs for rhinovirus or enterovirus that were sent automatically for EV-D68 testing. We compared characteristics and outcomes of patients with EV-D68 with those with rhinovirus or non–EV-D68 enterovirus in a matched cohort study.Results: A total of 93/297 (31.3%) of rhinovirus or enterovirus samples tested positive for EV-D68, and it was possible to compare 87 matched pairs. Children with EV-D68 infection were more likely to have difficulty breathing (odds ratio [OR] 3.00, 95% confidence interval [CI] 1.47–6.14). There was no significant difference in admission to the critical care unit or death among children with EV-D68 infection compared with those with other rhinovirus or enterovirus infections (adjusted OR 1.47, 95% CI 0.61–3.52). Children with EV-D68 infection were more often admitted to hospital, but not significantly so (adjusted OR 2.29, 95% CI 0.96–5.46).Interpretation: Enterovirus D68 seems to be a more virulent pulmonary pathogen than rhinovirus or non–EV-D68 enterovirus, but we did not find a significant difference in death or need for critical care.