@article{d5413ea73c004feba3cf4d98d7980c45,
title = "An increase in enterovirus D68 circulation and viral evolution during a period of increased influenza like illness, The Johns Hopkins Health System, USA, 2022",
abstract = "Background: An increase in influenza like illness in children and adolescents at the Johns Hopkins Health system during summer 2022 was associated with increased positivity for enterovirus/ rhinovirus. We sought to characterize the epidemiology and viral evolution of enterovirus D68 (EV-D68). Methods: A cohort of remnant respiratory samples tested at the Johns Hopkins Microbiology Laboratory was screened for EV-D68. EV-D68 positives were characterized by whole genome sequencing and viral loads were assessed by droplet digital PCR (ddPCR). Genomic changes and viral loads were analyzed along with patients{\textquoteright} clinical presentations. Results: Of 566 screened samples, 126 were EV-D68 (22.3%). The median age of EV-D68 infected patients was four years, a total of 52 required supplemental oxygen (41.3%), and 35 (27.8%) were admitted. Lung disease was the most frequent comorbidity that was associated with hospitalization. A total of 75 complete and 32 partial genomes were characterized that made a new cluster within the B3 subclade that was closest to US genomes from 2018. Amino acid changes within the BC and DE loops were identified from 31 genomes (29%) which correlated with an increase in average viral load in respiratory specimens and the need for supplemental oxygen. Conclusions: EV-D68 outbreaks continue to cause influenza like illness that could be overwhelming for the health system due to a significant demand for high flow oxygen. Viral evolution and an increase in the susceptible population are likely driving the trends of the increased EV-D68 infections.",
keywords = "EV-D68, Enterovirus, ILI, Respiratory",
author = "Amary Fall and Lijie Han and Omar Abdullah and Norton, {Julie M.} and Eldesouki, {Raghda E.} and Michael Forman and Morris, {C. Paul} and Eili Klein and Mostafa, {Heba H.}",
note = "Funding Information: HHM is supported by the HIV Prevention Trials Network (HPTN) sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), the Centers for Disease Control (contract 75D30121C11061 ), the Johns Hopkins Center of Excellence in Influenza Research and Surveillance ( HHSN272201400007C ), National Institute on Drug Abuse, National Institute of Mental Health , and Office of AIDS Research, of the NIH, DHHS (UM1 AI068613), the NIH RADx-Tech program ( 3U54HL143541-02S2 ), National Institute of Health RADx-UP initiative (Grant R01 DA045556-04S1 ), the Johns Hopkins department of Pathology, and the Maryland department of health. EK is supported by Centers for Disease Control and Prevention (CDC) MInD-Healthcare Program (Grant Number U01CK000589 ). The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Institute of Biomedical Imaging and Bioengineering; the National Heart, Lung, and Blood Institute; the National Institutes of Health, or the U.S. Department of Health and Human Services. Funding Information: This publication was made possible by support from the Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases, Division of Infectious Diseases of the Johns Hopkins University School of Medicine. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Fisher Center or Johns Hopkins University School of Medicine. Funding Information: HHM is supported by the HIV Prevention Trials Network (HPTN) sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), the Centers for Disease Control (contract 75D30121C11061), the Johns Hopkins Center of Excellence in Influenza Research and Surveillance (HHSN272201400007C), National Institute on Drug Abuse, National Institute of Mental Health, and Office of AIDS Research, of the NIH, DHHS (UM1 AI068613), the NIH RADx-Tech program (3U54HL143541-02S2), National Institute of Health RADx-UP initiative (Grant R01 DA045556-04S1), the Johns Hopkins department of Pathology, and the Maryland department of health. EK is supported by Centers for Disease Control and Prevention (CDC) MInD-Healthcare Program (Grant Number U01CK000589). The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Institute of Biomedical Imaging and Bioengineering; the National Heart, Lung, and Blood Institute; the National Institutes of Health, or the U.S. Department of Health and Human Services. Publisher Copyright: {\textcopyright} 2023 The Author(s)",
year = "2023",
month = mar,
doi = "10.1016/j.jcv.2023.105379",
language = "English (US)",
volume = "160",
journal = "Journal of Clinical Virology",
issn = "1386-6532",
publisher = "Elsevier",
}