Skip to main content

Advertisement

SpringerLink
Log in

Enterovirus D68-Associated Community-Acquired Pneumonia in the Pediatric Age Group

  • Respiratory Infections (F Arnold, Section Editor)
  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review summarizes the current knowledge regarding the role of Enterovirus D68 (EV-D68) in community-acquired pneumonia (CAP) in children.

Recent Findings

EV-D68 is an emergent viral pathogen. Since its first isolation in 1962 in California in four children suffering from CAP and bronchiolitis, EV-D68 has been rarely detected from respiratory specimens. However, recently, EV-D68 infection has raised concerns in the international community because of outbreaks in 2014 in the USA and the increased number of children with EV-D68-associated severe respiratory illnesses, including pneumonia, that have been reported in many other countries around the world.

Summary

EV-D68 causes severe and life-threatening respiratory diseases in the pediatric population, particularly in children with underlying conditions such as prematurity or chronic diseases. Since no specific treatment or vaccinations are available for EV-D68 infections, greater surveillance as well as the use of sensitive and rapid diagnostic methods are essential to prevent and manage new outbreaks.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. • Lugo D, Krogstad P. Enteroviruses in the early 21st century: new manifestation and challenges. Curr Opin Pediatr. 2016;28:107–13. An interesting review on clinical findings associated with Enteroviruses.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Khan F. Enterovirus D68 acute respiratory illness and the 2014 outbreak. Emerg Med Clin North Am. 2015;33:e19–32.

    Article  PubMed  Google Scholar 

  3. •• Principi N, Esposito S. Enterovirus D68: an emerging cause of infection. Expert Rev Respir Med. 2015;6:711–9. A comprehensive overview on Enterovirus D68.

    Article  Google Scholar 

  4. Schieble JH, Fox VL, Lennette EH. A probable new human picornavirus associated with respiratory disease. Am J Epidemiol. 1967;85:297–310.

    Article  CAS  PubMed  Google Scholar 

  5. Oermann CM, Schuster JE, Conners GP, Newland JG, Selvarangan R, Jackson MA. Enterovirus D68: a focused review and clinical highlights from the 2014 United States outbreak. Ann Am Thorac Soc. 2015;12:775–81.

    Article  PubMed  Google Scholar 

  6. Imamura T, Oshitani H. Global reemergence of enterovirus D68 as an important pathogen for acute respiratory infections. Rev Med Virol. 2015;25:102–14.

    Article  CAS  PubMed  Google Scholar 

  7. Midgley CM, Jackson MA, Selvaragan R, Turabelidze G, Obringer E, Johnoson D, et al. Severe respiratory illness associated with enterovirus D68—Missouri and Illinois, 2014. MMWR. 2014;63:798–9.

    PubMed  Google Scholar 

  8. Piralla A, Girello A, Grignani M, Gonzalo-Margüello M, Marchi A, Marseglia G, et al. Phylogenetic characterization of enterovirus 68 strains in patients with respiratory syndromes in Italy. J Med Virol. 2014;86:1590–3.

    Article  PubMed  Google Scholar 

  9. Maijer A, Benschop KS, Donker GA, van der Avoort HG. Continued seasonal circulation of enterovirus D68 in the Netherlands, 2011–2014. Eur Surveill. 2014;19:1–6.

    Google Scholar 

  10. Furuse Y, Chaimongkol N, Okamoto M, Imamura T, Saito M, Tamaki R, et al. Molecular epidemiology of entrovirus D68 from 2013 to 2014 in Philippines. J Clin Microbiol. 2015;53:1015–8.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Vongpunsaward S, Prachayagprecha S, Chnsaenroj J, Haagmans BL, Smits SL, Poovorawan Y. Genome sequence of enterovirus D68 and clinical disease, Thailand. Emerg Infect Dis. 2015;21:384.

    Article  Google Scholar 

  12. Wylie K, Wylie TN, Overdahl A, Buller RS, Herter BN, Magrini V, et al. Genome sequence of enterovirus D68 from St Louis, Missuri, USA. Emerg Infect Dis. 2015;21:184–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Zhang T, Lili R, Luo M, Li A, Gong C, Chen M, et al. Enterovirus D68-associated severe pneumonia, China 2014. Emerg Infect Dis. 2015;21:916–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Reiche J, Böttcher S, Diedrich S, Buchholz U, Buda S, Haas W, et al. Low-level circulation of enterovirus D68-associated acute respiratory infections, Germany, 2014. Emerg Infect Dis. 2015;21:837–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Torres J, Farfan MJ, Izquierdo G, Piemonte P, Henriquez J, O’Rayan ML. Enterovirus D68 infection, Chile, spring 2014. Emerg Infect Dis. 2015;21:728–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Midgley SE, Christianensen CB, Poulsen MW, Hansen CH, Fisher TK. Emergence of enterovirus D68 in Denmark, June 2014 to February 2015. Eur Surveill. 2015;20:1–6.

    Article  Google Scholar 

  17. Gimferrer L, Campins M, Codina MG, Esperalba J, Martin M, Fuentes F, et al. First enterovirus D68 (EV-D68) cases detected in hospitalized patients in a tertiary care university hospital in Spain, October 2014. Enferm Infect Microbiol Clin. 2015;33(9):585–9.

    Article  Google Scholar 

  18. Poelmann R, Schölvinck EH, Borger R, Niesters HGM, Van Leer-Buter C. The emergence of enterovirus D68 in a Dutch University Medical Centre and the necessity for routinely screening for respiratory viruses. J Med Virol. 2015;62:1–5.

    Google Scholar 

  19. Drews SJ, Simmonds K, Usman H, Yee K, Fathima S, Tipples G, et al. Characterization of enterovirus activity, including that of enterovirus D68, in pediatric patients in Alberta, Canada in 2014. J Clin Microbiol. 2015;53:1042–5.

    Article  PubMed  PubMed Central  Google Scholar 

  20. • Esposito S, Zampiero A, Ruggiero L, Madini B, Niesters H, Principi N. Enterovirus D68-associated community-acquired pneumonia in children living in Milan, Italy. J Clin Virol. 2015;68:94–6. Interesting case series on EV-D68 associated CAP.

    Article  PubMed  Google Scholar 

  21. Imamura T, Fuji N, Suzuki A, Tamaki R, Saito M, Aniceto R, et al. Enterovirus 68 among children with severe acute respiratory infection, the Philippines. Emerg Infect Dis. 2011;17:1430–35.

    PubMed  PubMed Central  Google Scholar 

  22. Abedi GR, Watson JT, Pham H, Nix WA, Oberste MS, Gerber SI. enterovirus and human paraechovirus surveillance: United States. MMWR Morb Mortal Wkly Rep. 2015;64:940–3.

    Article  PubMed  Google Scholar 

  23. Ikeda T, Mizuta K, Abiko C, Aoki Y, Itagaki T, Katsushima F, et al. Acute respiratory infections due to enterovirus 68 in Yamagata, Japan between 2005 and 2010. Microbiol Immunol. 2012;56:139–43.

    Article  CAS  PubMed  Google Scholar 

  24. Meijer A, van der Sanden S, Snijders BE, Jaramillo-Gutierrez G, Bont L, van der Ent CK, et al. Emergence and epidemic occurrence of enterovirus 68 respiratory infections in the Netherlands in 2010. Virology. 2012;423:49–57.

    Article  CAS  PubMed  Google Scholar 

  25. • Greninger A, Naccarche SN, Messacar K, Clayton A, Yu G, Somasekar S, et al. A novel outbreak enterovirus D68 strain associated with acute flaccid myelitis cases in the USA (2012–14): a retrospective cohort study. Lancet Infect Dis. 2015;15:1–12. A comprehensive retrospective description of acute flaccid myelitis cases associated with EV-D68.

    Article  Google Scholar 

  26. Pfeiffer HC, Bragstad K, Skram MK, Dahl H, Knudsen PK, Chawla MS, et al. Two cases of acute severe flaccid myelitis associated with enterovirus D68 infection in children, Norway, autumn 2014. Eur Surveill. 2015;20:1–5.

    Article  Google Scholar 

  27. Lang M, Mirand A, Savy N, Henquell C, Maridet S, Perignon R, et al. Acute flaccid paralysis following enterovirus D68 associated pneumonia, France, 2014. Eur Surveill. 2014;1:1–5.

    Google Scholar 

  28. •• Massacar K, Schreiner TL, Maloney JA, Wallace A, Ludke J, Oberste MS, et al. A cluster of acute flaccid paralysis and cranial nerve dysfunction temporally associated with an outbreak of enterovirus D68 in children in Colorado, USA. Lancet. 2015;385:1662–71. A complete description of neurologic involvement during EV-D68 outbreak.

    Article  Google Scholar 

  29. Murray JS, Mirch MC, Amin PM. Enterovirus D68: what pediatric healthcare professionals need to know. J Spec Pediatr Nurs. 2015;20:131–5.

    Article  PubMed  Google Scholar 

  30. Tokarz R, Firth C, Madhi SA, Howie SRC, Wu W, Sall AA, et al. Worldwide emergence of multiple clades of enterovirus 68. J Gen Virol. 2012;3:1952–8.

    Article  Google Scholar 

  31. • Du J, Zheng B, Zheng W, Li P, Kang J, Hou J, et al. Analysis of enterovirus 68 strains from the 2014 North America outbreak reveals a new clade indicating viral evolution. PLoS One. 2015;10, e0144208. An updated description documenting EV-D68 evolution.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Peci A, Winter AL, Warshwsky B, Booth TF, Eshaghi A, Li A, et al. Epidemiology of enterovirus D68 in Ontario. PLoS One. 2015;23, e0142841.

    Article  Google Scholar 

  33. Bragstad K, Jakobsen K, Rojahn AE, Skram MK, Vainio K, Holberg-Petersen M, et al. High frequency of enterovirus D68 in children hospitalized with respiratory illness in Norway, autumn 2014. Influenza Other Respir Viruses. 2015;9:59–63.

    Article  PubMed  Google Scholar 

  34. Mertz D, Alawfi A, Pernica JM, Rutherford C, Luinstra K, Smieja M. Clinical severity of pediatric respiratory illness with enterovirus D68 compared with rhinovirus or other enterovirus genotypes. CMAJ. 2015;187:1279–84.

    Article  PubMed  PubMed Central  Google Scholar 

  35. • Schuster JE, Miller JO, Selvarangan R, Weddle G, Thompson MT, Hassan F, et al. Severe enterovirus 68 respiratory illness in children requiring intensive care management. J Clin Virol. 2015;70:77–82. A detailed description of EV-D68 associated respiratory complications.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy

    Samantha Bosis & Susanna Esposito

  2. Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Piazza Menghini 1, 06129, Perugia, Italy

    Susanna Esposito

Authors
  1. Samantha Bosis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susanna Esposito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susanna Esposito.

Ethics declarations

Conflict of Interest

Drs Bosis and Esposito declare no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

Additional information

This article is part of the Topical Collection on Respiratory Infections

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bosis, S., Esposito, S. Enterovirus D68-Associated Community-Acquired Pneumonia in the Pediatric Age Group. Curr Infect Dis Rep 19, 12 (2017). https://doi.org/10.1007/s11908-017-0567-8

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11908-017-0567-8

Keywords

Search

Navigation