Clinical manifestations and etiological characteristics of the first enterovirus-D68 positive case in Fangshan district of Beijing

ObjectiveTo analyze the clinical manifestations and etiological characteristics of enterovirus D68 (EV-D68) infection in a patient with bronchopneumonia in Fangshan district of Beijing.

MethodsThe clinical data of the case were collected for disease progression and diagnosis/treatment analyses and the sputum sample collection of the case was done for the nucleic acid tests of 18 common respiratory pathogens. The sequences of VP1 gene region and complete genome of EV-D68 were amplified with pairs of primers and the sequence was used for genetic evolution analysis.

ResultsThe initial symptoms the bronchopneumonia case were high fever and cough, and respiratory symptoms of wheezing and coughing were exacerbated after high fever. The effect of anti-asthma drugs was significant. The sputum sample of this case was positive for EV-D68 and negative for other 17 pathogens. Phylogenetic analysis showed the pathogen belonged to EV-D68 subclade B3. Homology analysis showed that the EV-D68 strain shared high homology with Japanese strain in 2015 (98.72% nt, 99.95% aa), Hong Kong strain in 2015 (98.61% nt, 99.86% aa) and American strain in 2016 (98.24% nt, 99.86% aa), as well as " 2014-R132” strain in Beijing in 2014 (96.89% nt, 99.45% aa).

ConclusionEV-D68 was the important pathogen causing bronchopneumonia. It is necessary to strengthen the etiological surveillance for EV-D68 to provide evidence for the clinical diagnosis and control of EV-D68 infection.