Pediatrics Outcomes of EV-D68 Infections Not As Bad As Feared

Dominik Mertz, MD, MSc, FMH (CH) Assistant Professor, McMaster University Department of Medicine, Division of Infectious Diseases Associate Membership Department of Clinical Epidemiology and Biostatistics / Pathology and Molecular Medicine Medical Director Infection Prevention & Control, Hamilton Health Sciences Juravinski Hospital and Cancer Center Hamilton, ON, Canada

Dr. Mertz

MedicalResearch.com Interview with:
Dominik Mertz, MD, MSc, FMH (CH)
Assistant Professor, McMaster University
Department of Medicine, Division of Infectious Diseases
Associate Membership Department of Clinical Epidemiology and Biostatistics / Pathology and Molecular Medicine
Medical Director Infection Prevention & Control, Hamilton Health Sciences
Juravinski Hospital and Cancer Center
Hamilton, ON, Canada 

Medical Research: What is the background for this study? What are the main findings?

Dr. Mertz: There was a perception that there was an increase in ICU admissions and deaths, initially in Kansas City and Chicago, which was found to be related to the enterovirus strain EV-D68, which had previously not resulted in any major outbreaks in North America.

We have one of the first laboratories that was able to provide a specific EV-D68 PCR routine testing allowing us identify EV-D68 cases and to compare the outcomes in patients infected with this strain to children infected by other rhino/enteroviruses.

We found a substantial overlap in how the patients presented between patients with EV-D68 and non-EV-D68 infection. It seems that children infected with EV-D68 were in deed at higher risk for having respiratory distress and needing hospital admission, with children with allergies being at a higher risk. We did not find an increase in more severe outcomes, though, i.e. no higher risk for ICU admission (23 vs 15%) and 0 deaths in the EV-D68 group. We also did not find any evidence of in-hospital transmission of EV-D68.

Medical Research: What should clinicians and patients take away from your report?

Dr. Mertz: The report shows that EV-D68 was not as severe as the initial perception was. There was a high number of patients with infection with this strain last year which resulted in a large number of hospital- and ICU-admissions, but more severe outcomes were as likely in patients infected with non-EV-D68 strains.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Mertz: A comparison to other, more established viral pathogens such as influenza as RSV would be of interest, as would be the long-term effects of EV-D68 infections.

Citation:

Dominik Mertz, Abdulsalam Alawfi, Jeffrey M. Pernica, Candy Rutherford, Kathy Luinstra, and Marek Smieja

Clinical severity of pediatric respiratory illness with enterovirus D68 compared with rhinovirus or other enterovirus genotypesCMAJ cmaj.150619;

published ahead of print October 13, 2015,doi:10.1503/cmaj.150619

 

Dominik Mertz, MD, MSc (2015). Pediatrics Outcomes of EV-D68 Infections Not As Bad As Feared