Adriana Avery

Respiratory viruses have been a common occurrence in the human population. During the COVID-19 pandemic, the seasonality of these pathogens drastically changed, in response to mask mandates and social distancing. Historically, pathogens within the human enterovirus (EV) group and Influenza A & B (flu) have commonly infected both pediatric and adult populations. Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. The flu session typically occurs from December through March. The CDC states that between 3% and 11% of Americans become infected and develop flu symptoms each year (2019).  There are over one-hundred different enterovirus serotypes that infect humans (Shen, 2018) and we come into contact with enteroviruses on a daily basis (CDC, 2020). Generally, these pathogens cause acute respiratory symptoms and typically cases increase in April until December. In contrast, EV-D68, a strain of enterovirus that causes debilitating polio-like symptoms, has caused several outbreaks during the fall within the United States. Little is known about EV-D68 prevalence in asymptomatic pediatric populations, however, between 2009-2013, 4.3% of specimens sent to the National Enterovirus Surveillance System were positive for EV-D68 (Lugo, 2016). Today, after several EV-D68 outbreaks in the US, little information about the prevalence of EV-D68 is known.  We used remnant COVID-19 negative pediatric samples to conduct respiratory virus surveillance in Arizona during the COVID-19 pandemic, in hopes of better understanding trends and seasonality of respiratory viruses during the pandemic and in the future. Samples were extracted and real-time reverse transcriptase PCR, a cost-effective method for broad surveillance, was implemented to monitor the prevalence of flu viruses and human enteroviruses. A total of three published assays were used to monitor the prevalence of Flu, human Enteroviruses, and specifically an assay targeting EV-D68.