What is the clinical evidence from this study?

Study design: Case-Control. Population: Respiratory symptoms (suspected Enterovirus D68) (n=907). Intervention: Specimen collection in September vs. Specimen collection in October. Primary outcome: EV-D68 positivity (OR 8.07, 95% CI 5.15 to 12.64).

November 23, 2015PLoS ONEOpen Access

Epidemiology of Enterovirus D68 in Ontario

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Key result

EV-D68 cases were significantly more likely to be identified in September compared to October (OR 8.07), with peak positivity occurring in children aged 5-9 years.

Population

907 patients presenting with respiratory symptoms in different health care settings across Ontario, Canada…

Design

Case-control

Authors

APAdriana PeciPublic Health Ontario AWAnne‐Luise WinterPublic Health Ontario BWBryna WarshawskyWestern University

Discussion

Member takes

Implication

May guide early-fall respiratory testing in children; hypothesis-generating and requires prospective validation.

Study Design

Type

Case-Control (n=907)

Multicenter

Yes

Structured PICO

Population

907 patients (median age 3 years, 42% female) presenting with respiratory symptoms across Ontario, Canada, whose specimens were submitted for EV-D68 testing between September and October 2014.

Comparator

Patients testing negative for EV-D68 (controls)

Outcome

Epidemiology and clinical features associated with EV-D68 positivity

Main Result

Odds Ratio: 8.07 (95% CI 5.15–12.64)

EV-D68 was detected in 16.8% of tested patients in Ontario during September-October 2014, predominantly affecting young children and presenting with respiratory symptoms, with no significant difference in hospitalization rates compared to EV-D68 negative patients.

Limitations

PHOL was not the only laboratory performing EV-D68 testing in Ontario, so results do not represent all detections.
Physicians may not routinely test patients with mild respiratory symptoms, underestimating true incidence.
Different test methods used by PHOL and NML may have different sensitivity and specificity.
Reliance on inconsistently reported clinical information supplied by clinicians on laboratory requisitions.
Unable to report on clinical severity of disease or clinical outcome due to lack of patient chart review.
Underestimation of true incidence as mild cases may not present for care or be tested.
Potential testing bias towards at-risk groups (e.g., children with asthma) due to broad communication to clinicians.
Reliance on laboratory requisitions for clinical information without access to patient charts for disease severity or outcomes.

Cite This Study

Peci et al. (2015) conducted a case-control in Respiratory symptoms (suspected Enterovirus D68) (n=907). Specimen collection in September vs. Specimen collection in October was evaluated on EV-D68 positivity (OR 8.07, 95% CI 5.15 to 12.64). EV-D68 cases were significantly more likely to be identified in September compared to October (OR 8.07), with peak positivity occurring in children aged 5-9 years.

synapsesocial.com/papers/6a954eb42fdd6c151ff23439 https://doi.org/10.1371/journal.pone.0142841

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Epidemiology of Enterovirus D68 in Ontario

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Epidemiology of Enterovirus D68 in Ontario

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider