(NOTE: Post updated on October 6, 2014)
Multiple cases of Enterovirus D68 (EV-D68) have been confirmed in Wisconsin.
The first Wisconsin case was confirmed by the Centers for Disease Control and Prevention (CDC) on September 25th. (Wisconsin Department of Health Services news release).
Up-to-date figures for EV-D68 cases nationwide can be found on the CDC website.
EV-D68 is one of many non-polio enteroviruses and has been rarely isolated in the U.S. in the last 40 years. It has been reported to cause mild to severe respiratory illness, however, the full spectrum of illness is not well-defined. Severe symptoms may include difficulty breathing and wheezing, with asthmatic people at higher risk. The situation is developing rapidly and the CDC is watching and gathering information to better understand the situation. Information and guidance is being posted on the CDC website as it becomes available. The CDC is performing Enterovirus typing specific for EV-D68.
What should Wisconsin laboratories do if they are asked to perform testing for EV-D68?
- CDC and Wisconsin Division of Public Health are asking that only specimens from individuals who are in the pediatric intensive care unit (PICU) or inpatient pediatric clusters with severe respiratory disease be submitted to CDC for EV-D68 subtyping.
- Perform your normal diagnostic testing for rhinovirus/enterovirus (RV/ENT) respiratory infections. If the patient meets the above criteria, save at least a 1 ml aliquot of the specimen to send to the WSLH if the specimen is positive for RV/ENT. The aliquot can be stored at refrigerator temperature.
- Report individual PICU- admitted cases and inpatient pediatric clusters with severe respiratory illness (with or without fever) and positive for RV/ENT to your local public health department or the Wisconsin Division of Public Health (WDPH) at 608-267-9003 to coordinate testing.
- If testing is approved for EV-D68 by the WDPH:
- Submit the aliquot of the specimen on a cold pack to the Wisconsin State Laboratory of Hygiene (WSLH). The WSLH will test for RV/ENT using a single-plex PCR and submit the sample to the CDC for EV-D68 typing.
- Submit a completed routine WSLH requisition form, or a WSLH outbreak form along with the specimen:
- Clearly write on the form “for suspect EV-D68 testing”.
- Include the RV/ENT test results from your diagnostic testing.
- Clearly write on the form whether the patient is hospitalized in the PICU or part of a cluster.