BACKGROUND-AIM Enteroviruses (EVs) are recognized to cause mild-to-severe acute respiratory tract infection (ARI), a common illness among children. EVD68 has been identified as a worldwide emerging pathogen associated with severe respiratory symptoms since 2009. We report EVs and EVD68 detection in respiratory samples collected from children with ARI admitted to a University and research hospital in Milan (Italy), between January 2015 and December 2016. METHODS Respiratory samples (nasopharyngeal swabs, aspirates or broncho-alveolar lavages) were collected from 1638 children <15 years (median age: 10.7 months; IQR: 36 months) admitted to hospital with ARI; 50.4% were collected in 2015 (825/1638) and 49.6% (813/1638) in 2016. Overall, 45.5% (746/1638) of cases occurred during winter months; 78.5% (1286/1638) cases required admission to intensive care unit and were classified as severe ARI (SARI). After nucleic acids extraction (EZ1®DSP Kit, Qiagen), samples were tested for EV-RNA presence by multiplex real-time PCR (Anyplex™ II, RV16-Detection, Seegene); EV-positive specimens were analysed by real-time RT-PCR assay specific for EVD68. RESULTS 8.8% (144/1638) of samples were EV-positive. The median age of EV-positive children was 20.9 months (IQR: 37.2 months). 57.6% (83/144) of these were detected in 2016: the risk of EV infection was higher in 2016 than in 2015 (10.2% vs 7.4%; OR: 1.4; 95%CI: 1.1-2). Most (119/144: 82.6%) EV-positive samples were from SARI cases; 41.7% (60/144) occurred during summer months. Two-thirds (95/144: 66%) of EV-positive samples were tested for EVD68; among these, 19 (28.8%) were identified as EVD68. Nearly 90% (16/19) were from SARI cases. All but one (18/19: 94.7%) were identified in 2016, mostly (14/18: 77.8%) between July and October. CONCLUSIONS In this study, an EV infection was identified in nearly 9% of children admitted to hospital with respiratory illness. EV infections mostly occurred in children <3 years and brought to severe infection in >80% cases; the risk of EV infection was higher in 2016. EVD68 was detected in 2016 - mainly during the summer – causing severe respiratory infections. The set-up of a surveillance system to monitor the spread and clinical impact of EVs and particularly EVD68 is strongly recommended.

Enterovirus D68 (EVD68) in children with acute respiratory tract infection (ARI) admitted to a university and research hospital in Milan (Italy), from 2015 to 2016 / L. Pellegrinelli, S.C. Renteria Uceda, C. Galli, V. Primache, L. Greco, D. Guarnieri, A. Orlandi, E. Pariani, S. Esposito, G. Lunghi, S. Binda. ((Intervento presentato al convegno ESCV tenutosi a Stresa nel 2017.

Enterovirus D68 (EVD68) in children with acute respiratory tract infection (ARI) admitted to a university and research hospital in Milan (Italy), from 2015 to 2016

L. Pellegrinelli;C. Galli;V. Primache;L. Greco;A. Orlandi;E. Pariani;S. Esposito;S. Binda
2017-10

Abstract

BACKGROUND-AIM Enteroviruses (EVs) are recognized to cause mild-to-severe acute respiratory tract infection (ARI), a common illness among children. EVD68 has been identified as a worldwide emerging pathogen associated with severe respiratory symptoms since 2009. We report EVs and EVD68 detection in respiratory samples collected from children with ARI admitted to a University and research hospital in Milan (Italy), between January 2015 and December 2016. METHODS Respiratory samples (nasopharyngeal swabs, aspirates or broncho-alveolar lavages) were collected from 1638 children <15 years (median age: 10.7 months; IQR: 36 months) admitted to hospital with ARI; 50.4% were collected in 2015 (825/1638) and 49.6% (813/1638) in 2016. Overall, 45.5% (746/1638) of cases occurred during winter months; 78.5% (1286/1638) cases required admission to intensive care unit and were classified as severe ARI (SARI). After nucleic acids extraction (EZ1®DSP Kit, Qiagen), samples were tested for EV-RNA presence by multiplex real-time PCR (Anyplex™ II, RV16-Detection, Seegene); EV-positive specimens were analysed by real-time RT-PCR assay specific for EVD68. RESULTS 8.8% (144/1638) of samples were EV-positive. The median age of EV-positive children was 20.9 months (IQR: 37.2 months). 57.6% (83/144) of these were detected in 2016: the risk of EV infection was higher in 2016 than in 2015 (10.2% vs 7.4%; OR: 1.4; 95%CI: 1.1-2). Most (119/144: 82.6%) EV-positive samples were from SARI cases; 41.7% (60/144) occurred during summer months. Two-thirds (95/144: 66%) of EV-positive samples were tested for EVD68; among these, 19 (28.8%) were identified as EVD68. Nearly 90% (16/19) were from SARI cases. All but one (18/19: 94.7%) were identified in 2016, mostly (14/18: 77.8%) between July and October. CONCLUSIONS In this study, an EV infection was identified in nearly 9% of children admitted to hospital with respiratory illness. EV infections mostly occurred in children <3 years and brought to severe infection in >80% cases; the risk of EV infection was higher in 2016. EVD68 was detected in 2016 - mainly during the summer – causing severe respiratory infections. The set-up of a surveillance system to monitor the spread and clinical impact of EVs and particularly EVD68 is strongly recommended.
Settore MED/42 - Igiene Generale e Applicata
Enterovirus D68 (EVD68) in children with acute respiratory tract infection (ARI) admitted to a university and research hospital in Milan (Italy), from 2015 to 2016 / L. Pellegrinelli, S.C. Renteria Uceda, C. Galli, V. Primache, L. Greco, D. Guarnieri, A. Orlandi, E. Pariani, S. Esposito, G. Lunghi, S. Binda. ((Intervento presentato al convegno ESCV tenutosi a Stresa nel 2017.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/533593
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