Enterovirus D68 detection in respiratory specimens: Association with severe disease

Engelmann, Ilka; Fatoux, Marie; Lazrek, Mouna; Alidjinou, Enagnon K.; Mirand, Audrey; Henquell, Cécile; Dewilde, Anny; Hober, Didier

Molecular techniques increased the number of documented respiratory infections. In a substantial number of cases the causative agent remains undetected. Since August 2014, an increase in Enterovirus(EV)‐D68 infections was reported. We aimed to investigate epidemiology and clinical relevance of EV‐D68. From June to December 2014 and from September to December 2015, 803 and 847 respiratory specimens, respectively, were tested for respiratory viruses with a multiplex RT‐PCR. This multiplex RT‐PCR does not detect EV‐D68. Therefore, 457 (2014) and 343 (2015) specimens with negative results were submitted to an EV‐specific‐RT‐PCR. EV‐positive specimens were tested with an EV‐D68‐specific‐RT‐PCR and genotyped. Eleven specimens of 2014 tested positive in the EV‐specific‐RT‐PCR and of these seven were positive in the EV‐D68‐specific‐RT‐PCR. Typing confirmed these as EV‐D68. Median age of EV‐D68‐positive patients was 3 years (1 month‐91 years). Common symptoms included fever (n = 6, 86%), respiratory distress (n = 5, 71%), and cough (n = 4, 57%). All EV‐D68‐positive patients were admitted to hospital, 4 (57%) were admitted to intensive care units and 6 (86%) received oxygen. One patient suffered from acute flaccid paralysis. Seven specimens of 2015 were positive in the EV‐specific‐RT‐PCR but negative in the EV‐D68‐specific‐RT‐PCR. In conclusion, use of an EV‐specific‐RT‐PCR allowed us to detect EV‐D68 circulation in autumn 2014 that was not detected by the multiplex RT‐PCR and was associated with severe disease.