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.

Prevalence and Incidence

EV-D68 infection is considered extremely rare. The true prevalence and incidence are not known. Recent data suggests that increased awareness and earlier diagnosis of the disease might be attributed to a rising trend in prevalence of EV-D68.

USA

The Center for Disease Control (CDC) reports a total of 26 cases in USA between 1987 to 2005, 11 of which occurred in 2003 alone.[2] EV-D68 was reported in San Diego among military personnel in 2004-2005 and in New York City in 2009.

Philippines

During the period between October 2008 and March 2009, an outbreak of EV-D68 was detected in the Eastern Visayas region of the Philippines among pediatric patients hospitalized with pneumonia.[3]

Japan

In Japan, the first cases of EV-D68 were reported in 2005. From 2005 to 2010, less than 10 cases were discovered annually. However, almost 120 new cases occurred in 2010 alone. Most of the patients presented with an acute respiratory illness characterized by cough, breathing difficulty, or wheezing.[4]

Netherlands

In 2010, all patients with pneumonia and pneumonia-like symptoms were prospectively studied and their samples were sequenced. A total of 24 cases were attributed to EV-D68, 50% of which were less than 20 years of age.

Italy

Between 2008 and 2009, 12 cases of enterovirus 68 were reported in Italy among patients with viral respiratory infections.[5]

Age

  • Approximately 80% of reported cases of EV-D68 infection occurred among children.
  • The age at presentation ranges between 1 month to 78 years.
  • Based on older data, the median age at infection is 4-5 years; but new reports are consistently revealing adult preponderance[6][1][7]

Gender

Race

  • The prevalence of EV-D68 does not vary by race.

Geographical Distribution

Gender

  • Enterovirus 68 infection has been reported with more frequency in females than in males. [8][9][5][10][11]

References

  1. 1.0 1.1 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. 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)
  4. "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)
  5. 5.0 5.1 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.
  6. 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.
  7. "Clusters of Acute Respiratory Illness Associated with Human Enterovirus 68 --- Asia, Europe, and United States, 2008--2010".
  8. 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.
  9. 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.
  10. 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.
  11. 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.