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. 2016 May;10(3):154-60.
doi: 10.1111/irv.12384.

EV-D68 infection in children with asthma exacerbation and pneumonia in Mexico City during 2014 autumn

Joel A Vazquez-Perez  1 , Jose E Ramirez-Gonzalez  2 , Yazmin Moreno-Valencia  1 , Victor A Hernandez-Hernandez  1 , Jose A I Romero-Espinoza  1 , Manuel Castillejos-Lopez  1 , Andres Hernandez  1 , Rogelio Perez-Padilla  1 , Lizbeth E Oropeza-Lopez  1 , Noe Escobar-Escamilla  2 , Maribel Gonzalez-Villa  2 , Alejandro Alejandre-Garcia  1 , Justino Regalado-Pineda  1 , Patricio Santillan-Doherty  1 , Irma Lopez-Martínez  2 , Alberto Diaz-Quiñonez  2   3 , Jorge Salas-Hernandez  1
Affiliations

EV-D68 infection in children with asthma exacerbation and pneumonia in Mexico City during 2014 autumn

Joel A Vazquez-Perez et al. Influenza Other Respir Viruses. 2016 May.

Abstract

Background: Human enterovirus D68 (EV-D68) recently caused an increase in mild-to-severe pediatric respiratory cases in North America and some European countries. Even though few of these children presented with acute paralytic disease, direct causal relationship cannot yet be assumed.

Objectives: The purposes of this report were to describe the clinical findings of an outbreak of EV-D68 infection in Mexico City and identify the genetic relationship with previously reported strains.

Patients/methods: Between September and December 2014, 126 nasopharyngeal samples (NPS) of hospitalized children <15 years of age with ARI were tested for the presence of respiratory viruses using a multiplex RT-qPCR and EV-D68-specific RT-qPCR. Clinical, epidemiological, and demographic data were collected and associated with symptomatology and viral infections. Phylogenetic analyses were performed using VP1 region.

Results: Enterovirus/rhinovirus infection was detected in 40 patients (31·7%), of which 24 patients were EV-D68-positive. EV-D68 infection prevailed over September and October 2014 and was associated with neutrophilia and lymphopenia, and patients were more likely to develop hypoxemia. Phylogenetic analyses showed that Mexican EV-D68 belongs to the new B1 clade.

Conclusions: This is the first EV-D68 outbreak described in Mexico and occurred few weeks after the United States reported similar infections. Although EV-D68 belongs to new B1 clade, no neurological affection was observed.

Keywords: Enterovirus D68; epidemiology; outbreak; pediatric; respiratory viruses.

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Figures

Figure 1
Figure 1
Kaplan–Meier curves of hypoxemia probability according picornavirus infection. Patients rhinovirus‐ and enterovirus D68‐negative (EV/RV–negative, N = 86), and patients rhinovirus‐positive (N = 16) and enterovirus D68‐positive (N = 24). Hypoxemia probability was defined in Methods.
Figure 2
Figure 2
Maximum‐likelihood (ML) phylogenetic tree for EV‐D68 VP1 region. ML tree from 97 enterovirus D68 sequences registered in GenBank was calculated using partial VP1 region (453 bp) with 1000 bootstrap replicates. The sequence of 15 isolates from Mexico 2014, and eight strains from patients with acute flaccid myelitis were included (red arrows). Clades of EV‐D68 are indicated with square brackets. Bootstrap values (>70) are shown in each node.
See this image and copyright information in PMC

References

    1. van der Gugten AC, van der Zalm MM, Uiterwaal CS, Wilbrink B, Rossen JW, van der Ent CK. Human rhinovirus and wheezing: short and long‐term associations in children. Pediatr Infect Dis J 2013; 32:827–833. - PubMed
    1. Arden KE, Faux CE, O'Neill NT et al Molecular characterization and distinguishing features of a novel human rhinovirus (HRV) C, HRVC‐QCE, detected in children with fever, cough and wheeze during 2003. J Clin Virol 2010; 47:219–223. - PMC - PubMed
    1. Bizzintino J, Lee WM, Laing IA et al Association between human rhinovirus C and severity of acute asthma in children. Eur Respir J 2011; 37:1037–1042. - PMC - PubMed
    1. Cox DW, Bizzintino J, Ferrari G et al Human rhinovirus species C infection in young children with acute wheeze is associated with increased acute respiratory hospital admissions. Am J Respir Crit Care Med 2013; 188:1358–1364. - PMC - PubMed
    1. McIntyre MG, Stevens KM, Davidson S et al Centers for Disease Control and Prevention(CDC). Notes from the field: severe hand, foot, and mouth disease associated with coxsackievirus A6 ‐ Alabama, Connecticut, California, and Nevada, November 2011–February 2012. MMWR Morb Mortal Wkly Rep 2012; 61:213–214. - PubMed

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