CDC announces fast test for enterovirus D68

The Centers for Disease Control and Prevention (CDC) has developed a new laboratory test that detects the respiratory enterovirus D68 (EV-D68) more rapidly than the test currently in use. The CDC will use the new test to speed processing of the unusually numerous specimens submitted by the states since the largest-ever EV-D68 outbreak in the United States began in August.

The new test, which yields results in days rather than weeks, is a real-time reverse transcription-polymerase chain reaction that has fewer and shorter steps and can process more samples more quickly than its predecessor. It can identify all the strains of EV-D68 that have been seen in the current outbreak.

Using the new test will likely increase the number of confirmed EV-D68 cases initially as the CDC works through the backlog of specimens submitted since mid-September. Such an increase wouldn’t reflect real-time trends, however. Once the remaining specimens have been tested, the CDC expects to report results on newly submitted specimens within a few days.

That would help monitor when and where EV-D68 cases are declining, as they are expected to do by late fall, which is consistent with the seasonal summer-to-fall pattern for enteroviruses. Informal reports to the CDC suggest that EV-D68 infections are decreasing in some areas.

Enterovirus D68, which has been relatively rare until this year, has infected more than 900 persons, mostly children, in 46 states and the District of Columbia since mid-August. An unusually high number of children have been admitted to intensive care units with severe respiratory symptoms. Seven patients who tested positive for the virus have died. Polio-like muscle weakness also has been reported in a few cases.

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The outbreak has disproportionately affected children aged between 6 weeks and 16 years, with a median age of 5 years. Children with a history of asthma or wheezing have been especially hard hit.

In response, the American Academy of Pediatrics has urged pediatricians to consider EV-D68 when treating children with severe respiratory infections and scheduled a last-minute presentation on the enterovirus at its recent national conference.

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