2799. Inability to Locally Differentiate Rhinovirus/Enterovirus Results Impacts Infection Control Practices

Abstract Background Rhinoviruses and Enteroviruses are closely related members of the family picornavirideae; however, they have distinct clinical manifestations. Rhinoviruses cause respiratory infections while Enteroviruses often present as nonspecific febrile illnesses. Enterovirus D68 (EV-D68) is unusual in that although it is classified as an enterovirus it causes respiratory illness. Most of the currently used nucleic acid amplification assays for respiratory viruses do not distinguish between Rhino and Enteroviruses because of their shared homology. Rhino/Enterovirus infections are common in the Summer and Fall. In October of 2018 the NYS DOH issued a health advisory describing increased numbers of EV-D68 infection. Although there is no specific treatment for EV-D68, the advisory recommended contact precautions in addition to the droplet precautions recommended for other respiratory viruses. This recommendation creates logistical difficulties since there are no commercial test-kits that can identify EV-D68. The aim of this study was to determine the incidence of EV-D68 among patients admitted to Stony Brook Hospital that tested positive for Rhino/Enterovirus. Methods Nasopharyngeal swabs were tested with the BioFire® FilmArray® Respiratory Panel (RP 2) test. 44 Rhino/Enterovirus positive specimens were sent for further identification to the NYS DOH Virology Lab. Enterovirus was differentiated from Rhinovirus by qRT–PCR. EV-D68 was identified by sequencing. Results During one week in October, 10 patients were admitted with positive EV-D68 (5 adults and 5 children). In contrast, all 21 admitted patients who had specimens sent for typing had Rhinovirus. Conclusion This study confirmed that there was significant EV-D68 activity among patients who required hospitalization consistent with the NYS DOH advisory in the Fall of 2018. In contrast, in the Winter a drop in the prevalence of Rhino/enterovirus was observed. EV-D68 was not found in any of the samples sent for typing. These data informed our internal decision to cohort all patients this past Winter with positive Rhino/enterovirus results, positively impacting patient cohorting capabilities during a time with increased local influenza activity. Disclosures All authors: No reported disclosures.