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Amid Ebola preparation, an EV-D68 outbreak

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Karen Lusky

Labs ramp up for Ebola patients, specimens

December 2014—In addition to preparing for Ebola patients, many clinical laboratories and hospitals in recent months faced outbreaks of respiratory illness caused by enterovirus D68 among children.

“EV-D68 infections may be associated with severe acute respiratory illness, viral pneumonia, and severe reactive airway disease,” says Susan Novak, PhD, D(ABMM), director of microbiology at Kaiser Permanente Regional Reference Laboratories in Southern California. Focal limb weakness has also been reported as possibly related to EV-D68, she adds.

Dr. Novak

Dr. Novak

What’s interesting about EV-D68, says infectious disease physician Jose Romero, MD, “is that most of the children infected with the virus don’t have fever.” Also, according to reports from the Centers for Disease Control and Prevention, “approximately 60 percent to 70 percent of children have an underlying pulmonary problem like asthma or wheezing,” adds Dr. Romero, section chief of pediatric infectious diseases at Arkansas Children’s Hospital and professor of pediatrics at the University of Arkansas for Medical Sciences.

Susan Gerber, MD, the team lead for respiratory viruses in the CDC’s Division of Viral Diseases, says the CDC began in late August investigating reports of increased numbers of respiratory illnesses in some hospitals and U.S. jurisdictions. “That became the impetus for the MMWR report that came out in early September [which] looked at severe respiratory illnesses in Kansas City and Chicago,” she says (MMWR Morb Mortal Wkly Rep. 2014;63[36]:798–799).

Children’s Mercy Hospital in Kansas City, Mo., was the first to get the CDC on the virus’ trail, according to Rangaraj Selvarangan, BVSc, PhD, D(ABMM), director of the clinical microbiology laboratory. He says the laboratory uses the BioFire FilmArray Respiratory Panel, which detects enterovirus (EV)/rhinovirus (RhV). In mid-August, the laboratory began seeing an uptick in such detections.

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