Orvedahl Anthony, Padhye Amruta, Barton Kevin, O'Bryan Kevin, Baty Jack, Gruchala Nancy, Niesen Angela, Margoni Angeliki, Srinivasan Mythili
From the *Department of Pediatrics and †Division of Biostatistics, Washington University School of Medicine, St. Louis, MO; and ‡St. Louis Children's Hospital, St. Louis, MO.
Pediatr Infect Dis J. 2016 May;35(5):481-7. doi: 10.1097/INF.0000000000001060.
The largest known outbreak of enterovirus D68 (EV-D68) infections occurred during 2014. The goal of our study is to characterize the illness severity and clinical presentation of children infected with EV-D68 in comparison to non-EV-D68-human rhinoviruses/enteroviruses (HRV/EV).
Our study is a retrospective analysis of severity level, charges and length of stay of children who presented to St. Louis Children's Hospital from August 8, 2014 to October 31, 2014 and tested positive for EV-D68 in comparison to non-EV-D68-HRV/EV-infected patients. Chart review was performed for all EV-D68-infected patients and age and severity matched non-EV-D68-HRV/EV-infected patients.
There was a striking increase in hospital census in August of 2014 in our hospital with simultaneous increase in the number of patients with EV-D68 infection. There was no significant difference in severity of illness, length of stay or total charges between EV-D68-infected and non-EV-D68-HRV/EV-infected children. EV-D68 infection was characterized by presenting complaints of difficulty breathing (80%) and wheezing (67%) and by findings of tachypnea (65%), wheezing (71%) and retractions (65%) on examination. The most common interventions were albuterol (79%) and corticosteroid (68%) treatments, and the most common discharge diagnosis was asthma exacerbation (55%).
EV-D68 caused a significant outbreak in 2014 with increased hospital admissions and associated increased charges. There was no significant difference in severity of illness caused by EV-D68 compared with non-EV-D68-HRV/EV infections suggesting that the impact from EV-D68 was because of increased number of infected children presenting to the hospital and not necessarily due to increased severity of illness.
已知最大规模的肠道病毒D68（EV-D68）感染疫情于2014年发生。我们研究的目的是比较感染EV-D68的儿童与非EV-D68型人鼻病毒/肠道病毒（HRV/EV）感染儿童的疾病严重程度和临床表现。
我们的研究是对2014年8月8日至2014年10月31日就诊于圣路易斯儿童医院且EV-D68检测呈阳性的儿童的严重程度、费用和住院时间进行回顾性分析，并与非EV-D68-HRV/EV感染患者进行比较。对所有感染EV-D68的患者以及年龄和严重程度匹配的非EV-D68-HRV/EV感染患者进行病历审查。
2014年8月我院住院人数显著增加，同时EV-D68感染患者数量也增加。感染EV-D68的儿童与非EV-D68-HRV/EV感染的儿童在疾病严重程度、住院时间或总费用方面没有显著差异。EV-D68感染的特征表现为呼吸困难主诉（80%）和喘息（67%），检查发现呼吸急促（65%）、喘息（71%）和三凹征（65%）。最常见的治疗措施是沙丁胺醇（79%）和皮质类固醇（68%）治疗，最常见的出院诊断是哮喘加重（55%）。
2014年EV-D68引发了一次大规模疫情，导致住院人数增加及相关费用上升。与非EV-D68-HRV/EV感染相比，EV-D68所致疾病严重程度没有显著差异，这表明EV-D68的影响是由于到医院就诊的感染儿童数量增加，而不一定是疾病严重程度增加。
