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PostPosted: Tue Sep 16, 2014 12:50 pm 
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Media reports cite confirmation of 18 EV-D68 cases in Alberta, Canada.

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PostPosted: Tue Sep 16, 2014 12:52 pm 
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WATCH ABOVE: Su-Ling Goh has more on Enterovirus D68 in the province, and what Alberta Health Services wants parents to know.

EDMONTON – A respiratory virus that’s affected hundreds of children across the U.S. may have arrived in Alberta. It’s called Enterovirus D68 (EV-D68).

Alberta Health Services has confirmed 18 cases of the virus in our province since August, all in hospitalized patients under the age of 18. Five of those cases were in Edmonton, 10 were in Calgary.

The provincial lab is now testing to see if it’s the same strain of EV-D68 as the one causing problems in the U.S.

Even though hospitals across the provinces are seeing more children with respiratory viruses lately, Dr. James Talbot — Alberta Health’s chief medical officer of health — says that happens every fall as kids go back to school.

“Every fall at this time, you’ll have people going, ‘oh my kids came home with something, or there’s something circulating in the office.’ And it’s often enterovirus and this time we know it’s D68.

“But we haven’t had any deaths and we’re seeing activity that’s increased as it normally is this time of year.”

WATCH: A serious respiratory illness that’s been spreading through parts of the United States has now crossed the border into Canada. There’s always a spike in viruses when kids return to school, but the severity of this strain of Enterovirus is raising concern. Shirlee Engel explains.

http://globalnews.ca/news/1565062/ahs-c ... -province/

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PostPosted: Wed Sep 17, 2014 12:29 am 
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http://globalnews.ca/news/1567637/three ... ed-in-b-c/
Quote:
September 16, 2014 10:43 pm
Three cases of enterovirus confirmed in B.C.
By Peter Meiszner Global News

A rare but typically mild respiratory virus is sending hundreds of U.S. kids to the emergency room.
Canadian Press

A serious respiratory illness that’s been spreading through parts of the U.S. has now shown up in B.C.

There are now three confirmed cases of enterovirus in B.C., according to the BC Centre for Disease Control.

There are already 18 confirmed cases in Alberta. In Ontario, 12 kids are undergoing tests for the disease.

Symptoms of the enterovirus are similar to the common cold, but for children with pre-existing respiratory conditions like asthma it can be much more dangerous.

The virus has already caused the hospitalization of hundreds of people — mostly children — across the U.S.


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PostPosted: Wed Sep 17, 2014 7:45 am 
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HUMAN ENTEROVIRUS 68 - CANADA: (ALBERTA)
****************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Mon 15 Sep 2014
From: Kevin Fonseca <Kevin.Fonseca@albertahealthservices.ca> [edited]


We report the detection and confirmation of EV68 [now designated enterovirus D68] in recent hospitalized pediatric cases at a major pediatric tertiary centre in Calgary. Our findings complement earlier reports of EV68 respiratory infections reported from the Midwest USA states (see ProMED posts 20140908.2757391 and 20140908.2758285). Taken together, this information supports a more widespread geographical distribution of this respiratory agent, now both in the USA and Canada, coincident with an increase in visits to emergency departments, some of which may be related to exacerbations of respiratory conditions.

From 1-11 Sep 2014, the Alberta Childrens Hospital (ACH), Calgary, one of the 2 major pediatric centres in Alberta, noted a significant increase in the number of patients admitted compared with the same period last year [2013]. We identified 9 cases of EV68 among children hospitalized at the ACH with an admitting diagnosis of asthma or bronchiolitis during this period. Two were transferred to the pediatric ICU, of whom one required continuous positive air pressure (CPAP), and 4 needed supplemental oxygen. Three cases had a prior history of asthma, and a 4th had a prior admission for an RSV [respiratory syncytial virus] infection; none of the other 5 children had a prior hospital admission for a respiratory complication. The ages of the patients ranged from 22 months to 12 years, 4 of whom were female.

In a 2 step algorithm at the Provincial Laboratory, these samples 1st tested negative for influenza A and B viruses, hence they were then tested in the XTAG Respiratory Viral Panel (RVP, Luminex, Austin, TX, USA), which also includes the entero/rhinoviruses group; previously, we found this assay able to detect EV68 strains. Although the RVP assay detects both rhinoviruses and enteroviruses, it does not distinguish between them; therefore, samples positive for entero/rhinovirus were selected for further testing. Enteroviruses were distinguished from rhinoviruses through an in-house RT-PCR assay specifically targeting the 5 NCR of enteroviruses, which were then typed by sequencing. Portions of the following genes namely, 5 non-coding region (293 bp), VP4 (207 bp) and VP2 (250 bp), were amplified and sequenced using the primers and methodology of Coiras et al, 2004. Sequence alignment and phylogenetic comparisons of the VP2 region were performed against representative sequences in GenBank.

Phylogenetic comparisons of the 9 strains show they are closely similar but significantly divergent from the prototype Fermon strain isolated 1962 (Schieble et al., 1967) and from relatively recent USA strains deposited in 2009. The closest match was to GenBank number KM361524. As there are no sequences deposited in a publicly accessible database of the recent Midwest cases, we cannot determine the similarity between our strains and theirs.

In summary, we have found EV68 to be circulating in Alberta; further studies are on-going to determine when this agent 1st appeared, the diversity of circulating strains, and the clinical presentation associated with this emerging virus.

[Lead and corresponding authors:

Kevin Fonseca, Clinical Virologist, Provincial Laboratory of Public Health, Alberta, Canada
James D Kellner, Professor and Head, Department of Paediatrics, University of Calgary and Alberta Health Services, Calgary Zone

Additional contributing authors in alphabetical order by organization and last name:

Alberta Health: James Talbot, Chief Medical Officer of Health, Alberta Health, Canada
Kimberley Simmonds, Manager, Infectious Disease Epidemiology, Surveillance & Assessment Branch
Alberta Childrens Hospital, Calgary, Alberta, Canada
Mark Anselmo, Pediatric Respiratory Medicine
Susan Kuhn, Head, Section of Infectious Diseasesvprovincial Laboratory of Public Health, Alberta, Canada
Sumana Fathima, Surveillance and Health Information Officer
Kanti Pabbaraju, Senior Scientist
Graham Tipples, Medical/Scientific Director
Raymond Tellier, Medical Microbiologist
Sallene Wong, Scientist]

--
Kevin Fonseca
<Kevin.Fonseca@albertahealthservices.ca>

[ProMED-mail thanks Kevin Fonseca for provision of this detailed account of the identification of enterovirus D68 in Albertan patients suffering severe respiratory infections. It is likely that enterovirus D68 virus is causing outbreaks of severe respiratory infection throughout North America. - Mod.CP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/263.]

See Also

Human enterovirus 68 - USA (06): (NY) conf. 20140914.2773026
Human enterovirus 68 USA (05): (CT) susp 20140913.2771924
Human enterovirus 68 - USA (04): update, RFI 20140910.2763945
Human enterovirus 68 - USA (03): midwest, CDC 20140908.2758285
Human enterovirus 68 - USA (02): children, susp across Midwest 20140908.2757391
Human enterovirus 68 - USA: (Kansas City, MO) 20140830.2737051
2011
----
Human enterovirus 68 (02): comment 20111005.2994
Human enterovirus 68 - novel pathogen, worldwide 20110929.2945
2010
----
Non-polio enteroviruses & parechoviruses, 2006-2008 - USA 20101209.4394
2009
----
Enteroviruses and diabetes 20090308.0959
.................................................cp/msp/lm

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