Journal of Clinical Virology - Volume 82 - Supplement 1 - September 2016

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S10 Abstracts / Journal of Clinical Virology 82S (2016) S1–S142
Abstract no: 289
Presentation at ESCV 2016: Oral 17
Enterovirus D68 diagnosed in severe respiratory
and neurological illness in children during
2015–2016 season in Portugal
R. Guiomar ∗, I. Costa , P. Pechirra ,
P. Palminha , C. Ribeiro , C. Roque , M.J. Peres ,
R. Viseu , M.J. Balseiro , M.J. Brito , J. Neves ,
P. Branquinho , R. Côrte-Real
1 National Influenza and Other Respiratory Viruses
Reference Laboratory, Infectious Diseases
Department, National Institute of Health Dr. Ricardo
Jorge, Lisbon, Portugal
2 National Reference Laboratory for Vaccine
Preventable Diseases, Infectious Diseases
Department, National Institute of Health Dr. Ricardo
Jorge, Lisbon, Portugal
3 Immunology and Molecular Biology Laboratory,
Allergy and Clinical Immunology Department, Centro
Hospitalar de Setúbal, Portugal
4 Paediatrics Department, Centro Hospitalar de
Setúbal, Portugal
5 Infecciology Unit, Hospital Dona Estefânia, Centro
Hospitalar Lisboa Central, Portugal
6 Clinical Pathology – Molecular Biology Laboratory,
Centro Hospitalar Lisboa Central, Portugal
Background: Enterovirus D68 (EV-D68) was first isolated in
1962, and since then associated with respiratory illness. The
report of severe respiratory and neurological disease including
deaths associated to EV-D68 in United States and Canada during
August 2014 highlighted the need of epidemiological information
regarding EV-D68 circulation. In Europe information was scarce,
available only for few countries. In Portugal there was no data
available and was critical to know the epidemiology of EV-D68,
especially in children hospitalized with severe respiratory or neu-
rological disease. This study aims to identify EV-D68 in Enterovirus
positive respiratory samples in children under 18with clinical diag-
nosis of severe respiratory infection or neurological illness.
Methods: During 2015/16 winter season, between
November/2015 and March/2016, 29 EV positive cases were
reported to the National Influenza and Other Respiratory Virus
Reference Laboratory (NIC) by two hospitals located in Lisbon
and Setubal districts. EV diagnosis was performed in hospi-
tals by biomolecular methods using commercial kits (real time
multiplex-PCR, FTD Respiratory pathogens 21 and CLART Pneu-
movir, Genomica, respectively). EV-D68 was diagnosed by an in
house real-time PCR irus isolation in RD cell line and phylo-
genentic analysis of the VP1/VP3 genomic regions will enable the
identification of genetic groups in circulation. All samples were
irreversibly anonymized. Demographic and clinical data were
collected.
Results: EV-D68 was confirmed in 20 respiratory samples pre-
viously positive for EV (69%; 20/29). Samples were collected from
children with age ranging from 2 months to 6 years old, both gen-
ders (9 female; 11 male) with diagnosis of severe respiratory or
neurological illness. Eighteen cases were hospitalized (90%; 18/20).
Bronchiolitis and pneumonia were the most frequently reported
diagnosis, corresponding to 70% (14/20). Two cases have neuro-
logic diagnosis. EV-D68 was identified throughout all study period
with the higher number of positive cases detected during January
2016, in week 3. Virus isolation and genetic characterization are
under way with expected results in virus phylogeny and evalua-
tion on similarity with recent circulating strains in United States,
Canada and European countries.
Conclusions: EV-D68 was detected in a high positive rate (69%)
among EV positive cases. This positive rate of EV-D68 was higher
compared to the positivity rate of 10.2%, calculated in a European
study during 2014 his finding could be linked to the selection
of severe and hospitalized patients in present study, highlight-
ing the involvement of EV-D68 with severe respiratory disease
in children. The identification of EV-D68 is also crucial in respi-
ratory samples in children with clinical diagnosis of neurological
illness. This study is the first attempt to describe the prevalence of
EV-D68 in severe paediatric cases, in Portugal. The strength of EV-
D68 surveillance in paediatric and adult population at the national
level will be important to understand the epidemiology of EV-D68,
age-related susceptibility and association with disease severity.
References
[1] R. Poelman, et al., J. Clin. Virol. 62 (2015) 1–5,
.
[2] R. Poelman, et al., J. Clin. Virol. 71 (2015) 1–9,
.
Abstract no: 189
Presentation at ESCV 2016: Oral 18
Evaluation of TTV load kinetics among kidney
transplant recipients in the first year
post-transplant period
Antonio Piralla ∗, Alessia Girello ,
Marta Premoli , Umberto Palatini ,
Fausto Baldanti
1 Molecular Virology Unit, Microbiology and Virology
Department, Fondazione IRCCS Policlinico San
Matteo, Pavia, Italy
2 Section of Microbiology, Department of Clinical,
Surgical, Diagnostic and Pediatric Sciences,
University of Pavia, Pavia, Italy
Introduction: Torque teno virus (TTV) is highly prevalent in
humans (90%) with a persistent low-level viremia in the immuno-
competent host. Patients who undergo kidney transplant have a
high risk of blood-borne viral infections, including the TTV. The
objectives of this study are: (i) to assess the level and kinetics of
TTV DNA in patients after kidney transplantation; (ii) to investi-
gate the possible association with different conditioning regimens
and the kinetics of TTV DNA load; and (iii) to correlate the TTV DNA
level with the post-transplant immune reconstitution.
Material and methods: TTVDNA load was assessed in a series
of blood samples collected at 15, 30, 60, 90, 180, and 360 days after
transplant from 78 kidney transplant recipients (KTRs) prospec-
tively monitored for opportunistic virus infections at the Molecular
Virology Unit, Fondazione IRCCS Policlinico San Matteo. The total
T-cell, T-CD4+, and T-CD8+ lymphocyte countswere retrospectively
retrieved at the same time points used for the TTV DNA load anal-
ysis.
Results: In 72/78 (92.3%) patients, TTV DNA was detected at
15 days after transplantation. At 60 days after transplantation, all
patients were positive for TTV infection. In 29/78 (37.2%) patients,
the peak of viral load was reached at 180 days after transplanta-
tion, in 24/78 (30.8%) at 360 days and in 20/78 (25.6%) at 90 days.
Only 4 (5.1%) and 1 (1.3%) patients reached the peak of viral load
at 60 and 15 days after transplantation, respectively. A significant
increase of TTV DNA load was observed between 15 days (median