Prevalence and epidemiology of enterovirus species in a pediatric oncology patient population

Abstract

Background

Enteroviruses (EV) are associated with a range of syndromes including respiratory infections. Non-polio enteroviruses like EV-D68 can cause more severe symptoms in children, and immunocompromised individuals. The goal of this study was to determine the prevalence and genotypes of EV in a pediatric oncology patient population.

Methods

Pediatric patients (<18 years old) testing positive for Rhinovirus/Enterovirus (RV/EV) by multiplexed respiratory pathogens panels between September and December 2022 and 2023 were included in the study. RV/EV positive nasopharyngeal swabs (NPS) specimens were further characterized using pan-enterovirus RT-PCR, EV-D68 RT-PCR and Whole genome sequencing (WGS). Clinical characteristics of EV positive patients and matched controls were extracted from the clinical information system.

Results

Across the two study periods, 3.8 % (9/238) and 3.6 % (8/225) EV were identified in RV/EV positives NPS in 2022 and 2023 respectively. The most prevalent EV species were EV-D68 (3/9, 33 %) and Coxsackievirus A6 (3/9, 33 %). All three patients with EV-D68 were male with an underlying diagnosis of acute lymphoblastic lymphoma or neuroblastoma. Besides, the EV-D68 detections were only from the 2022 NPS samples. There were no differences in symptoms severity between patients with or without EV infections.

Conclusions

The prevalence of EV during the study periods was low in this patient population and not associated with severe symptoms. However, further exploration is required to understand the relationship between EV infection and patient symptoms since this study was limited by the low EV detection. Larger studies are needed to further characterize EV infections in this patient population.