Avram Levy1, Jason Roberts2, Jurissa Lang3, Simone Tempone4, Alison Kesson5, Alfred Dofai6, Andrew J Daley7, Bruce Thorley2, David J Speers8. 1. PathWest Laboratory Medicine WA, Perth, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia. Electronic address: Avram.levy@health.wa.gov.au. 2. National Enterovirus Reference Laboratory, VIDRL, Doherty Institute, Melbourne, Australia; School of Applied Sciences, RMIT University, Melbourne, Australia. 3. PathWest Laboratory Medicine WA, Perth, Australia. 4. PathWest Laboratory Medicine WA, Perth, Australia; Current affiliate: Communicable Disease Control Directorate, Health Department of Western Australia, Perth, Australia. 5. Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Paediatrics and Child health and the Marie Bashir Institute for Emerging Infectious Diseases and Biosecurity, Sydney Medical School, Sydney, Australia. 6. National Referral Hospital, Honiara, Solomon Islands. 7. The Royal Children's Hospital, Melbourne, Australia; The University of Melbourne, Department of Paediatrics, Melbourne, Australia. 8. PathWest Laboratory Medicine WA, Perth, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia.
Abstract
BACKGROUND: Enterovirus D68 (EV-D68) has received considerable recent attention as a cause of widespread respiratory illness. Neurological syndromes such as acute flaccid paralysis following EV-D68 infection have also been reported in a small number of cases. OBJECTIVES: To summarize the clinical and epidemiological characteristics of laboratory confirmed EV-D68 cases in Australia. STUDY DESIGN: We combined EV-D68 data acquired through laboratory surveillance in Western Australia with cases from national enterovirus surveillance and regional acute flaccid paralysis (AFP) surveillance. Clinical data was obtained for EV-D68 cases and capsid protein sequences were used for phylogenetic analysis. RESULTS: Sporadic cases of EV-D68 were recorded in Australia since 2008, with peaks in activity during 2011 and 2013. EV-D68 was primarily associated with respiratory disease, but was also detected in cerebrospinal fluid of one patient and faeces of two patients presenting with AFP. CONCLUSIONS: EV-D68 has been circulating in Western Australia and is likely to have also been present in the wider region for a number of years, causing primarily respiratory disease. Detection of EV-D68 in cerebrospinal fluid of one patient and in faeces of two AFP cases reinforces the association between EV-D68 and neurological disease.
BACKGROUND:Enterovirus D68 (EV-D68) has received considerable recent attention as a cause of widespread respiratory illness. Neurological syndromes such as acute flaccid paralysis following EV-D68infection have also been reported in a small number of cases. OBJECTIVES: To summarize the clinical and epidemiological characteristics of laboratory confirmed EV-D68 cases in Australia. STUDY DESIGN: We combined EV-D68 data acquired through laboratory surveillance in Western Australia with cases from national enterovirus surveillance and regional acute flaccid paralysis (AFP) surveillance. Clinical data was obtained for EV-D68 cases and capsid protein sequences were used for phylogenetic analysis. RESULTS: Sporadic cases of EV-D68 were recorded in Australia since 2008, with peaks in activity during 2011 and 2013. EV-D68 was primarily associated with respiratory disease, but was also detected in cerebrospinal fluid of one patient and faeces of two patients presenting with AFP. CONCLUSIONS:EV-D68 has been circulating in Western Australia and is likely to have also been present in the wider region for a number of years, causing primarily respiratory disease. Detection of EV-D68 in cerebrospinal fluid of one patient and in faeces of two AFP cases reinforces the association between EV-D68 and neurological disease.
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