Enterovirus 68 epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]; Alejandro Lemor, M.D. [3]

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Overview

The current increase in respiratory disease due to infection with EV-68 may be a consequence of a misidentification of previous cases, attributed then to infections with rhinovirus, or simply due to improved case detection.[1] Until recently, the CDC reported a low prevalence of EV-68 infection, with a total of 26 cases in USA from 1987-2005, 11 of which occurring in 2003. Infection with EV-68 is more frequent in females and in children, although, more studies regarding the age incidence are required. Other countries in which recent cases of infection with EV-68 have been reported include: the Philippines, Japan, Netherlands, and Italy.

Epidemiology and Demograhics

EV68 infection is extremely rare; in fact, the Center for Disease Control (CDC) reports a total of 26 cases in USA from 1987-2005, 11 of which occurred in 2003.[2] EV68 infection was first reported in 1962 in California among four children with pneumonia and bronchioloitis[3] and since then only a few cases have been discovered. However, there have been recent outbreaks in other parts of the world.[4][5][1] Recently, five cases of unexplained flaccid paralysis were reported in California. In two of these cases, EV68 was isolated. However, a clear role of EV68's involvement still needs to be explained. EV-D68 was notified in San Diego, USA in military personnel in 2004-2005 and in respiratory surveillance screens in France and Italy in 2008. It was also documented in Philippines and in Japan. In USA EV-D68 was found and reported by CDC in NYC in 2009

Philippines:

During the period of October 2008 and March 2009, an outbreak of EV68 was detected in the Eastern Visayas region of the Philippines among pediatric patients hospitalized with pneumonia.[6]

Japan:

In Japan, the first cases of EV68 were reported in 2005. From 2005 to 2010, less than 10 cases were discovered almost every year; however, almost 120 cases occurred in 2010. Most of the patients presented with an acute respiratory illness characterized by cough, breathing difficulty or wheezing.[7]

Netherlands:

In 2010, all patients with pneumonia and pneumonia like symptoms were prospectively studied and their samples were sequenced. A total of 24 patients were attributed to EV68, 50% of which were in the age group less than 20 years.

Finland:

EV-68 has a high prevalence in Finland.[8][9]

Italy:

Between 2008 and 2009, 12 cases of enterovirus 68 were reported in Italy among patients with viral respiratory infections.[10]

Age

  • The majority of reported cases (80%) of enterovirus 68 infection occurred in children, specially in younger than 5 years old. [11][1][12]
  • Even though children are more commonly affected, enterovirus 68 infection also has been reported among patients aged between 40 and 59 years.[13]

Gender

  • Enterovirus 68 infection has been reported with more frequency in females than in males. [14][15][10][16][13]

References

  1. 1.0 1.1 1.2 Tokarz R, Firth C, Madhi SA, Howie SR, Wu W, Sall AA; et al. (2012). "Worldwide emergence of multiple clades of enterovirus 68". J Gen Virol. 93 (Pt 9): 1952–8. doi:10.1099/vir.0.043935-0. PMC 3542132. PMID 22694903.
  2. Khetsuriani, N.; Lamonte-Fowlkes, A.; Oberst, S.; Pallansch, MA. (2006). "Enterovirus surveillance--United States, 1970-2005". MMWR Surveill Summ. 55 (8): 1–20. PMID 16971890. Unknown parameter |month= ignored (help)
  3. Schieble, JH.; Fox, VL.; Lennette, EH. (1967). "A probable new human picornavirus associated with respiratory diseases". Am J Epidemiol. 85 (2): 297–310. PMID 4960233. Unknown parameter |month= ignored (help)
  4. Lauinger, IL.; Bible, JM.; Halligan, EP.; Aarons, EJ.; MacMahon, E.; Tong, CY. (2012). "Lineages, sub-lineages and variants of enterovirus 68 in recent outbreaks". PLoS One. 7 (4): e36005. doi:10.1371/journal.pone.0036005. PMID 22536453.
  5. Oberste, MS.; Maher, K.; Schnurr, D.; Flemister, MR.; Lovchik, JC.; Peters, H.; Sessions, W.; Kirk, C.; Chatterjee, N. (2004). "Enterovirus 68 is associated with respiratory illness and shares biological features with both the enteroviruses and the rhinoviruses". J Gen Virol. 85 (Pt 9): 2577–84. doi:10.1099/vir.0.79925-0. PMID 15302951. Unknown parameter |month= ignored (help)
  6. Imamura, T.; Fuji, N.; Suzuki, A.; Tamaki, R.; Saito, M.; Aniceto, R.; Galang, H.; Sombrero, L.; Lupisan, S. (2011). "Enterovirus 68 among children with severe acute respiratory infection, the Philippines". Emerg Infect Dis. 17 (8): 1430–5. doi:10.3201/eid1708.101328. PMID 21801620. Unknown parameter |month= ignored (help)
  7. "Clusters of acute respiratory illness associated with human enterovirus 68--Asia, Europe, and United States, 2008-2010". MMWR Morb Mortal Wkly Rep. 60 (38): 1301–4. 2011. PMID 21956405. Unknown parameter |month= ignored (help)
  8. Smura T, Ylipaasto P, Klemola P, Kaijalainen S, Kyllönen L, Sordi V; et al. (2010). "Cellular tropism of human enterovirus D species serotypes EV-94, EV-70, and EV-68 in vitro: implications for pathogenesis". J Med Virol. 82 (11): 1940–9. doi:10.1002/jmv.21894. PMID 20872722.
  9. Blomqvist S, Savolainen C, Råman L, Roivainen M, Hovi T (2002). "Human rhinovirus 87 and enterovirus 68 represent a unique serotype with rhinovirus and enterovirus features". J Clin Microbiol. 40 (11): 4218–23. PMC 139630. PMID 12409401.
  10. 10.0 10.1 Piralla, Antonio; Girello, Alessia; Grignani, Michela; Gozalo-Margüello, Monica; Marchi, Antonietta; Marseglia, Gianluigi; Baldanti, Fausto (2014). "Phylogenetic characterization of enterovirus 68 strains in patients with respiratory syndromes in Italy". Journal of Medical Virology. 86 (9): 1590–1593. doi:10.1002/jmv.23821. ISSN 0146-6615.
  11. Piralla, Antonio; Lilleri, Daniele; Sarasini, Antonella; Marchi, Antonietta; Zecca, Marco; Stronati, Mauro; Baldanti, Fausto; Gerna, Giuseppe (2012). "Human rhinovirus and human respiratory enterovirus (EV68 and EV104) infections in hospitalized patients in Italy, 2008–2009". Diagnostic Microbiology and Infectious Disease. 73 (2): 162–167. doi:10.1016/j.diagmicrobio.2012.02.019. ISSN 0732-8893.
  12. "Clusters of Acute Respiratory Illness Associated with Human Enterovirus 68 --- Asia, Europe, and United States, 2008--2010".
  13. 13.0 13.1 Meijer, Adam; van der Sanden, Sabine; Snijders, Bianca E.P.; Jaramillo-Gutierrez, Giovanna; Bont, Louis; van der Ent, Cornelis K.; Overduin, Pieter; Jenny, Shireen L.; Jusic, Edin; van der Avoort, Harrie G.A.M.; Smith, Gavin J.D.; Donker, Gé A.; Koopmans, Marion P.G. (2012). "Emergence and epidemic occurrence of enterovirus 68 respiratory infections in The Netherlands in 2010". Virology. 423 (1): 49–57. doi:10.1016/j.virol.2011.11.021. ISSN 0042-6822.
  14. Lu, Q.-B.; Wo, Y.; Wang, H.-Y.; Wei, M.-T.; Zhang, L.; Yang, H.; Liu, E.-M.; Li, T.-Y.; Zhao, Z.-T.; Liu, W.; Cao, W.-C. (2013). "Detection of enterovirus 68 as one of the commonest types of enterovirus found in patients with acute respiratory tract infection in China". Journal of Medical Microbiology. 63 (Pt_3): 408–414. doi:10.1099/jmm.0.068247-0. ISSN 0022-2615.
  15. Imamura, Tadatsugu; Suzuki, Akira; Lupisan, Socorro; Kamigaki, Taro; Okamoto, Michiko; Roy, Chandra Nath; Olveda, Remigio; Oshitani, Hitoshi (2014). "Detection of enterovirus 68 in serum from pediatric patients with pneumonia and their clinical outcomes". Influenza and Other Respiratory Viruses. 8 (1): 21–24. doi:10.1111/irv.12206. ISSN 1750-2640.
  16. Jacobson, Lara M.; Redd, John T.; Schneider, Eileen; Lu, Xiaoyan; Chern, Shur-Wern W.; Oberste, M. Steven; Erdman, Dean D.; Fischer, Gayle E.; Armstrong, Gregory L.; Kodani, Maja; Montoya, Jennifer; Magri, Julie M.; Cheek, James E. (2012). "Outbreak of Lower Respiratory Tract Illness Associated With Human Enterovirus 68 Among American Indian Children". The Pediatric Infectious Disease Journal. 31 (3): 309–312. doi:10.1097/INF.0b013e3182443eaf. ISSN 0891-3668.