• Dominik Mertz, Abdulsalam Alawfi, Jeffrey M Pernica, Candy Rutherford, Kathy Luinstra, and Marek Smieja.
• Departments of Medicine (Mertz, Alawfi, Smieja), Clinical Epidemiology and Biostatistics (Mertz, Smieja), Pathology and Molecular Medicine (Mertz, Smieja); Michael G. DeGroote Institute for Infectious Diseases Research (Mertz, Smieja); Department of Pediatrics (Pernica, Smieja), McMaster University; Hamilton Regional Laboratory Medicine Program (Rutherford, Smieja); Department of Laboratory Medicine (Luinstra, Smieja), St. Joseph's Healthcare, Hamilton, Ont. mertzd@mcmaster.ca.
• CMAJ. 2015 Nov 17; 187 (17): 1279-1284.

BackgroundEnterovirus D68 (EV-D68) resulted in a reported increase in the number of children needing hospital or critical care admission because of respiratory insufficiency during 2014. It remains unclear, however, whether EV-D68 infections were more severe than rhinovirus or non-EV-D68 enterovirus infections.MethodsWe evaluated consecutive children presenting to a pediatric hospital between Aug. 1 and Oct. 31, 2014, with positive nasopharyngeal swabs for rhinovirus or enterovirus that were sent automatically for EV-D68 testing. We compared characteristics and outcomes of patients with EV-D68 with those with rhinovirus or non-EV-D68 enterovirus in a matched cohort study.ResultsA total of 93/297 (31.3%) of rhinovirus or enterovirus samples tested positive for EV-D68, and it was possible to compare 87 matched pairs. Children with EV-D68 infection were more likely to have difficulty breathing (odds ratio [OR] 3.00, 95% confidence interval [CI] 1.47-6.14). There was no significant difference in admission to the critical care unit or death among children with EV-D68 infection compared with those with other rhinovirus or enterovirus infections (adjusted OR 1.47, 95% CI 0.61-3.52). Children with EV-D68 infection were more often admitted to hospital, but not significantly so (adjusted OR 2.29, 95% CI 0.96-5.46).InterpretationEnterovirus D68 seems to be a more virulent pulmonary pathogen than rhinovirus or non-EV-D68 enterovirus, but we did not find a significant difference in death or need for critical care.© 2015 Canadian Medical Association or its licensors.

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