Esposito Susanna, Bosis Samantha, Niesters Hubert, Principi Nicola
Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Department of Medical Microbiology, Division of Clinical Virology, University Medical Center, The University of Groningen, 9713 Groningen, The Netherlands.
Viruses. 2015 Nov 24;7(11):6043-50. doi: 10.3390/v7112925.
First described in 1962 in children hospitalized for pneumonia and bronchiolitis, the Enterovirus D68 (EV-D68) is an emergent viral pathogen. Since its discovery, during the long period of surveillance up to 2005, EV-D68 was reported only as a cause of sporadic outbreaks. In recent years, many reports from different countries have described an increasing number of patients with respiratory diseases due to EV-D68 associated with relevant clinical severity. In particular, an unexpectedly high number of children have been hospitalized for severe respiratory disease due to EV-D68, requiring intensive care such as intubation and mechanical ventilation. Moreover, EV-D68 has been associated with acute flaccid paralysis and cranial nerve dysfunction in children, which has caused concerns in the community. As no specific antiviral therapy is available, treatment is mainly supportive. Moreover, because no vaccines are available, conventional infection control measures (i.e., standard, for contacts and droplets) in both community and healthcare settings are recommended. However, further studies are required to fully understand the real importance of this virus. Prompt diagnosis and continued surveillance of EV-D68 infections are essential to managing and preventing new outbreaks. Moreover, if the association between EV-D68 and severe diseases will be confirmed, the development of adequate preventive and therapeutic approaches are a priority.
肠道病毒D68(EV-D68)于1962年首次在因肺炎和支气管炎住院的儿童中被描述,是一种新出现的病毒病原体。自发现以来,在长达2005年的长期监测期间,EV-D68仅被报告为散发性疫情的病因。近年来,来自不同国家的许多报告描述了越来越多因EV-D68导致呼吸道疾病的患者,且伴有相关的临床严重程度。特别是,因EV-D68导致严重呼吸道疾病而住院的儿童数量出乎意料地高,需要进行诸如插管和机械通气等重症监护。此外,EV-D68与儿童急性弛缓性麻痹和颅神经功能障碍有关,这引起了社会的关注。由于没有可用的特异性抗病毒疗法,治疗主要是支持性的。此外,由于没有可用的疫苗,建议在社区和医疗机构采取常规感染控制措施(即针对接触者和飞沫的标准措施)。然而,需要进一步研究以充分了解这种病毒的真正重要性。对EV-D68感染进行及时诊断和持续监测对于管理和预防新的疫情至关重要。此外,如果EV-D68与严重疾病之间的关联得到证实,开发适当的预防和治疗方法将成为优先事项。