Authors:
Alpana Waghmare, Steven A. Pergam, Keith R. Jerome, Janet A. Englund, Michael Boeckh, and Jane Kuypers
Summary:
The US Centers for Disease Control reported over a thousand cases of severe respiratory disease in pediatric patients associated with enterovirus-D68 (EV-D68) in the fall of 2014. We sought to identify and define the clinical burden of disease due to EV-D68 in adult patients with hematologic malignancy or undergoing hematopoietic cell transplant (HCT). Real-time RT-PCR for EV-D68 was performed on all respiratory samples positive for human rhinovirus (HRV) or negative for all respiratory viruses by a laboratory-developed respiratory viral PCR panel from 8/11/2014 to 11/7/2014. Presumptive cases were defined as those with an EV-D68 PCR cycle threshold (CT) at least 4 cycles lower than the HRV CT for HRV+ samples, or any EV-D68 CT value for HRV- samples. Sequencing of a 150 base-pair fragment of the 5' non-coding region confirmed EV-D68 in 16 of 506 respiratory samples. Eight patients had a history of hematologic malignancy and 6 of these had undergone HCT. Presentation ranged from mild upper respiratory symptoms to respiratory failure. EV-D68 can infect adult patients with hematologic malignancy and HCT recipients, and may be associated with severe respiratory disease. Current commercial diagnostic assays cannot differentiate EV-D68 from other enteroviruses or HRV, and improved rapid diagnostic tools are needed.
Source:
Blood; (01/15/15)