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Volume 30, Number 3—March 2024
Synopsis

Multimodal Surveillance Model for Enterovirus D68 Respiratory Disease and Acute Flaccid Myelitis among Children in Colorado, USA, 2022

Kevin MessacarComments to Author , Shannon Matzinger, Kevin Berg, Kirsten Weisbeck, Molly Butler, Nicholas Pysnack, Hai Nguyen-Tran, Emily Spence Davizon, Laura Bankers, Sarah A. Jung, Meghan Birkholz, Allison Wheeler, and Samuel R. Dominguez
Author affiliations: Children’s Hospital Colorado, Aurora, Colorado, USA (K. Messacar, M. Butler, H. Nguyen-Tran, S.A. Jung, M. Birkholz, S.R. Dominguez); University of Colorado, Aurora (K. Messacar, H. Nguyen-Tran, S.R. Dominguez); Colorado Department of Public Health and Environment, Denver, Colorado, USA (S. Matzinger, K. Berg, K. Weisbeck, N. Pysnack, E. Spence Davizon, L. Bankers, A. Wheeler)

Main Article

Figure 2

Multimodal surveillance during EV-D68 outbreak in Colorado, USA, 2022. A) Multimodal EV-D68 syndromic, clinical laboratory, and wastewater surveillance. To simplify the presentation of the temporal relationship between clinical positivity rates and the signal in wastewater, the viral concentrations of EV-D68 for the 3 utilities in this study are aggregated. B) Syndromic surveillance for asthma-like respiratory disease. C) Clinical laboratory surveillance for EV-D68 respiratory disease at CHCO. D) Wastewater surveillance for EV-D68 by wastewater utility service area. To generate the line presented in the graph, the concentration values for the 3 utilities were added together and averaged (mean) by sample collection date. The sample collection dates and cadence were uniform over time across all 3 utilities. The data are an estimation of the overall viral signal from the adjacent sewershed areas within the Denver metropolitan region (panel D; Appendix Figure 1). AFM, acute flaccid myelitis; CDC, Centers for Disease Control and Prevention; CHCO, Children’s Hospital Colorado; CHPHE, Colorado Department of Public Health and Environment; EV, enterovirus; HAN, Health Alert Network; RV, rhinovirus.

Figure 2. Multimodal surveillance during EV-D68 outbreak in Colorado, USA, 2022. A) Multimodal EV-D68 syndromic, clinical laboratory, and wastewater surveillance. To simplify the presentation of the temporal relationship between clinical positivity rates and the signal in wastewater, the viral concentrations of EV-D68 for the 3 utilities in this study are aggregated. B) Syndromic surveillance for asthma-like respiratory disease. C) Clinical laboratory surveillance for EV-D68 respiratory disease at CHCO. D) Wastewater surveillance for EV-D68 by wastewater utility service area. To generate the line presented in the graph, the concentration values for the 3 utilities were added together and averaged (mean) by sample collection date. The sample collection dates and cadence were uniform over time across all 3 utilities. The data are an estimation of the overall viral signal from the adjacent sewershed areas within the Denver metropolitan region (panel D; Appendix Figure 1). AFM, acute flaccid myelitis; CDC, Centers for Disease Control and Prevention; CHCO, Children’s Hospital Colorado; CHPHE, Colorado Department of Public Health and Environment; EV, enterovirus; HAN, Health Alert Network; RV, rhinovirus.

Main Article

Page created: January 31, 2024
Page updated: February 22, 2024
Page reviewed: February 22, 2024
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