Author/Authors :
Martin, Georgina Department of Pediatrics - University of Saskatchewan, Saskatoon, Canada , Li, Rachel Department of Pediatrics - British Columbia Children’s Hospital, Vancouver, Canada , Cook, Victoria E. Division of Allergy and Clinical Immunology - British Columbia Children’s Hospital, Vancouver, Canada , Carwana, Matthew Department of Pediatrics - British Columbia Children’s Hospital, Vancouver, Canada , Tilley, Peter Pathology & Lab Medicine - British Columbia Children’s Hospital, Vancouver, Canada , Sauve, Laura Division of Infectious Diseases - British Columbia Children’s Hospital, Vancouver, Canada , Tang, Patrick British Columbia Centre for Disease Control, Vancouver, Canada , Kapur, Akshat Division of Respiratory Medicine - British Columbia Children’s Hospital, Vancouver, Canada , Yang, Connie L. Division of Respiratory Medicine - British Columbia Children’s Hospital, Vancouver, Canada
Abstract :
Background. In the fall of 2014, a North American outbreak of enterovirus D68 resulted in a significant number of pediatric
hospital admissions for respiratory illness throughout North America. This study characterized the clinical presentation and risk
factors for a severe clinical course in children admitted to British Columbia Children’s Hospital during the 2014 outbreak. Methods.
Retrospective chart review of patients with confirmed EV-D68 infection admitted to BCCH with respiratory symptoms in the fall of
2014. Past medical history, clinical presentation, management, and course in hospital was collected and analyzed using descriptive
statistics. Comparison was made between those that did and did not require ICU admission to identify risk factors. Results. Thirtyfour patients were included (median age 7.5 years). Fifty-three percent of children had a prior history of wheeze, 32% had other
preexisting medical comorbidities, and 15% were previously healthy. Ten children (29%) were admitted to the pediatric intensive
care unit. The presence of complex medical conditions (excluding wheezing) (𝑃 = 0.03) and copathogens was associated with
PICU admission (𝑃 = 0.02). Conclusions. EV-D68 infection resulted in severe, prolonged presentations of asthma-like illness in the
hospitalized pediatric population. Patients with a prior history of wheeze and preexisting medical comorbidities appear to be most
severely affected, but the virus can also cause wheezing in previously well children
