2015
DOI: 10.1016/s2213-2600(15)00335-5
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Severe respiratory illness associated with a nationwide outbreak of enterovirus D68 in the USA (2014): a descriptive epidemiological investigation

Abstract: Summary Background Enterovirus D68 (EV-D68) has been infrequently reported historically, and is typically associated with isolated cases or small clusters of respiratory illness. Beginning in August, 2014, increases in severe respiratory illness associated with EV-D68 were reported across the USA. We aimed to describe the clinical, epidemiological, and laboratory features of this outbreak, and to better understand the role of EV-D68 in severe respiratory illness. Methods We collected regional syndromic surv… Show more

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Cited by 199 publications
(213 citation statements)
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“…EV and PeV type surveillance in the United States was affected by the 2014 EV-D68 outbreak ( 1 ); this type accounted for 68% of identified types in 2014 and 56% of all reported types during 2014–2016. Increased vigilance and the need for rapid identification of new cases led to a large increase in diagnostic testing for EV and respiratory viruses among patients with respiratory illness during the late summer and autumn months of 2014.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…EV and PeV type surveillance in the United States was affected by the 2014 EV-D68 outbreak ( 1 ); this type accounted for 68% of identified types in 2014 and 56% of all reported types during 2014–2016. Increased vigilance and the need for rapid identification of new cases led to a large increase in diagnostic testing for EV and respiratory viruses among patients with respiratory illness during the late summer and autumn months of 2014.…”
Section: Discussionmentioning
confidence: 99%
“…Recent outbreaks, such as those of EV-D68–associated respiratory illness, CV-A6–associated severe hand, foot, and mouth disease, and a cluster of severe PeV-A3 infections among infants ( 1 , 3 , 5 ), highlight the continuing need for robust EV and PeV type surveillance. The associations between certain EV and PeV types and specific clinical manifestations have been well documented, but the epidemiology and associated clinical syndromes of many other EV and PeV types remain poorly characterized.…”
Section: Discussionmentioning
confidence: 99%
“…EV-D68 cases have been increasing in frequency and severity over the last decade, with outbreaks in the US in 2014 and 2016 (Midgley et al, 2015; Wang et al, 2017). It is likely that the number of cases is severely under-reported, as only the most severe clinical presentations are tested for EV-D68, allowing many infections to go undetected as asymptomatic or mild flu-like cases (Oberste et al, 2004).…”
Section: Introductionmentioning
confidence: 99%
“…During late summer and fall of 2014, a large outbreak of severe respiratory disease in young children occurred across the United States, with laboratory confirmation of EV-D68 infection in Ͼ1,100 cases (http://www.cdc.gov/non -polio-enterovirus/outbreaks/EV-D68-outbreaks.html). The outbreak was characterized by a severe disease, often requiring intensive care and noninvasive ventilatory support, that particularly affected children with a history of asthma or reactive airway disease (4,30). Cases were also reported in Canada and Europe (5,6).…”
mentioning
confidence: 99%