J Infect Dis
. 2024 Mar 28:jiae154.
doi: 10.1093/infdis/jiae154. Online ahead of print. Epidemiological and clinical insights into the enterovirus D68 upsurge in Europe 2021/22 and the emergence of novel B3-derived lineages, ENPEN multicentre study
Margarida Pires Simoes 1 2 , Emma B Hodcroft 3 4 5 , Peter Simmonds 6 , Jan Albert 7 8 , Enagon K Alidjinou 9 , Katia Ambert-Balay 10 , Cristina Andrés 11 , Andrés Antón 11 , Christelle Auvray 10 , Jean-Luc Bailly 12 , Fausto Baldanti 13 14 , Capser Bastings 15 , Stuart Beard 16 , Carla Berengua Pereira 17 , Natasa Berginc 18 , Mandy Bloemen 19 , Soile Blomqvist 20 , Froukje Bosma 21 , Sindy Böttcher 22 , Laura Bubba 23 , Stafan Buderus 24 , Maria Cabrerizo 25 , Christina Calvo 26 , Christina Celma 16 , Ferruccio Ceriotti 27 , Gemma Clark 28 , Inës Costa 29 , Marianne Coste-Burel 30 , Karen Couderé 31 , Jeroen Cremer 1 , Margarita Del Cuerpo Casas 17 , Theo Daehne 32 , Jessica de Beer 21 , Maria de Ceano-Vivas 26 , Cillian De Gascun 33 , Alexis de Rougemont 10 , Johnathan Dean 33 , Jennifer L Dembinski 34 , Sabine Diedrich 22 , Javier Diez-Domingo 35 , Lena Dillner 36 , Dagny H Dorenberg 34 , Alexandra Ducancelle 37 , Susanne Dudman 38 39 , Robert Dyrdak 7 8 , Anna-Maria Eis-Huebinger 40 , Iker Falces-Romero 41 , Agnes Farkas 42 , Susan Feeney 43 , Maria D Fernandez-Garcia 44 , Jacky Flipse 45 , Kristina T Franck 46 , Cristina Galli 47 , Isabelle Garrigue 48 , Felix Geeraedts 21 , Irina Georgieva 49 , Federica Giardina 13 , Raquel Guiomar 29 , Elenor Hauzenberger 36 , Esther Heikens 50 , Cécille Henquell 51 , Didier Hober 9 , Amrio Hönemann 52 , Hannah Howson-Wells 28 , Željka Hruškar 53 , Niina Ikonen 20 , Berthemarie Imbert 30 , Arjan R Jansz 15 , Marion Jeannoël 54 , Helena Jiřincová 55 , Laurence Josset 54 , Kathrin Keeren 56 , Naomie Kramer-Lindhout 57 , Sidsel Krokstad 58 , Mouna Lazrek 9 , Hélène Le Guillou-Guillemette 37 , Caroline Lefeuvre 37 , Andreas Lind 38 , Maja M Lunar 59 , Melanie Maier 52 , Stéphanie Marque-Juillet 60 , C Patrick McClure 28 61 , James McKenna 43 , Adam Meijer 1 , Ana Menasalvas Ruiz 62 , Beatriz Mengual-Chuliá 35 , Sofie Midgley 46 , Audrey Mirand 12 51 , Richard Molenkamp 63 , Milagrosa Montes 64 , Antonio Moreno-Docón 65 , Ursula Morley 33 , Jean-Luc Murk 31 , Ana Navascués-Ortega 66 , Roel Nijhuis 67 , Lubomira Nikolaeva-Glomb 49 , Svein A Nordbø 68 , Sanela Numanovic 34 , Massimo Oggioni 69 , Eider Oñate Vergara 64 , Jordi Pacaud 48 , Marie L Pacreau 60 , Marcus Panning 32 , Elena Pariani 47 , Lili Pekova 70 , Laura Pellegrinelli 47 , Miroslav Petrovec 71 , Corinna Pietsch 52 , Léa Pilorge 72 , Luis Piñeiro 64 , Antonio Piralla 13 , Mario Poljak 59 , Birgit Prochazka 73 , Nuria Rabella 17 , Janette C Rahamat-Langendoen 63 , Petra Rainetova 55 , Marijke Reynders 74 , Annelies Riezebos-Brilman 21 , Lieuwe Roorda 75 , Carita Savolainen-Kopra 20 , Isabelle Schuffenecker 54 , Leo C Smeets 76 , Ayse Stoyanova 49 , Karl Stefic 77 , Caroline Swanink 45 , Irena Tabain 53 , Jeroen Tjhie 15 31 , Luc Thouault 72 , Camille Tumiotto 48 , Sara Uceda Renteria 27 , Tina Uršič 71 , Sophie Vallet 72 , Marc Van Ranst 19 , Peter Van Wunnik 76 , Jaco J Verweij 31 , Jorgina Vila 11 , Bas Wintermans 57 , Elke Wollants 19 , Katja C Wolthers 78 , F Xavier López-Labrado 35 , Thea Kolsen Fischer 79 80 , Heli Harvala 81 82 , Kimberley S M Benschop 1
Affiliations
Enterovirus D68 (EV-D68) infections are associated with severe respiratory disease and acute flaccid myelitis (AFM). The European Non-Polio Enterovirus Network (ENPEN) aimed to investigate the epidemiological and genetic characteristics of EV-D68 and its clinical impact during the fall-winter season of 2021/22. From 19 European countries, 58 institutes reported 10,481 (6.8%) EV-positive samples of which 1,004 (9.6%) were identified as EV-D68 (852 respiratory samples). Clinical data was reported for 969 cases. 78.9% of infections were reported in children (0-5 years); 37.9% of cases were hospitalised. Acute respiratory distress was commonly noted (93.1%) followed by fever (49.4%). Neurological problems were observed in 6.4% of cases with six reported with AFM. Phylodynamic/Nextstrain and phylogenetic analyses based on 694 sequences showed the emergence of two novel B3-derived lineages, with no regional clustering. In conclusion, we describe a large-scale EV-D68 European upsurge with severe clinical impact and the emergence of B3-derived lineages.
Keywords: B3-derived lineages; European Non-Polio Enterovirus Network (ENPEN); acute flaccid myelitis (AFM); acute flaccid paralysis (AFP); coronavirus disease caused by SARS-CoV-2 (COVID-19); enterovirus D68 (EV-D68); non-polio enterovirus (NPEV); respiratory infection; surveillance.
. 2024 Mar 28:jiae154.
doi: 10.1093/infdis/jiae154. Online ahead of print. Epidemiological and clinical insights into the enterovirus D68 upsurge in Europe 2021/22 and the emergence of novel B3-derived lineages, ENPEN multicentre study
Margarida Pires Simoes 1 2 , Emma B Hodcroft 3 4 5 , Peter Simmonds 6 , Jan Albert 7 8 , Enagon K Alidjinou 9 , Katia Ambert-Balay 10 , Cristina Andrés 11 , Andrés Antón 11 , Christelle Auvray 10 , Jean-Luc Bailly 12 , Fausto Baldanti 13 14 , Capser Bastings 15 , Stuart Beard 16 , Carla Berengua Pereira 17 , Natasa Berginc 18 , Mandy Bloemen 19 , Soile Blomqvist 20 , Froukje Bosma 21 , Sindy Böttcher 22 , Laura Bubba 23 , Stafan Buderus 24 , Maria Cabrerizo 25 , Christina Calvo 26 , Christina Celma 16 , Ferruccio Ceriotti 27 , Gemma Clark 28 , Inës Costa 29 , Marianne Coste-Burel 30 , Karen Couderé 31 , Jeroen Cremer 1 , Margarita Del Cuerpo Casas 17 , Theo Daehne 32 , Jessica de Beer 21 , Maria de Ceano-Vivas 26 , Cillian De Gascun 33 , Alexis de Rougemont 10 , Johnathan Dean 33 , Jennifer L Dembinski 34 , Sabine Diedrich 22 , Javier Diez-Domingo 35 , Lena Dillner 36 , Dagny H Dorenberg 34 , Alexandra Ducancelle 37 , Susanne Dudman 38 39 , Robert Dyrdak 7 8 , Anna-Maria Eis-Huebinger 40 , Iker Falces-Romero 41 , Agnes Farkas 42 , Susan Feeney 43 , Maria D Fernandez-Garcia 44 , Jacky Flipse 45 , Kristina T Franck 46 , Cristina Galli 47 , Isabelle Garrigue 48 , Felix Geeraedts 21 , Irina Georgieva 49 , Federica Giardina 13 , Raquel Guiomar 29 , Elenor Hauzenberger 36 , Esther Heikens 50 , Cécille Henquell 51 , Didier Hober 9 , Amrio Hönemann 52 , Hannah Howson-Wells 28 , Željka Hruškar 53 , Niina Ikonen 20 , Berthemarie Imbert 30 , Arjan R Jansz 15 , Marion Jeannoël 54 , Helena Jiřincová 55 , Laurence Josset 54 , Kathrin Keeren 56 , Naomie Kramer-Lindhout 57 , Sidsel Krokstad 58 , Mouna Lazrek 9 , Hélène Le Guillou-Guillemette 37 , Caroline Lefeuvre 37 , Andreas Lind 38 , Maja M Lunar 59 , Melanie Maier 52 , Stéphanie Marque-Juillet 60 , C Patrick McClure 28 61 , James McKenna 43 , Adam Meijer 1 , Ana Menasalvas Ruiz 62 , Beatriz Mengual-Chuliá 35 , Sofie Midgley 46 , Audrey Mirand 12 51 , Richard Molenkamp 63 , Milagrosa Montes 64 , Antonio Moreno-Docón 65 , Ursula Morley 33 , Jean-Luc Murk 31 , Ana Navascués-Ortega 66 , Roel Nijhuis 67 , Lubomira Nikolaeva-Glomb 49 , Svein A Nordbø 68 , Sanela Numanovic 34 , Massimo Oggioni 69 , Eider Oñate Vergara 64 , Jordi Pacaud 48 , Marie L Pacreau 60 , Marcus Panning 32 , Elena Pariani 47 , Lili Pekova 70 , Laura Pellegrinelli 47 , Miroslav Petrovec 71 , Corinna Pietsch 52 , Léa Pilorge 72 , Luis Piñeiro 64 , Antonio Piralla 13 , Mario Poljak 59 , Birgit Prochazka 73 , Nuria Rabella 17 , Janette C Rahamat-Langendoen 63 , Petra Rainetova 55 , Marijke Reynders 74 , Annelies Riezebos-Brilman 21 , Lieuwe Roorda 75 , Carita Savolainen-Kopra 20 , Isabelle Schuffenecker 54 , Leo C Smeets 76 , Ayse Stoyanova 49 , Karl Stefic 77 , Caroline Swanink 45 , Irena Tabain 53 , Jeroen Tjhie 15 31 , Luc Thouault 72 , Camille Tumiotto 48 , Sara Uceda Renteria 27 , Tina Uršič 71 , Sophie Vallet 72 , Marc Van Ranst 19 , Peter Van Wunnik 76 , Jaco J Verweij 31 , Jorgina Vila 11 , Bas Wintermans 57 , Elke Wollants 19 , Katja C Wolthers 78 , F Xavier López-Labrado 35 , Thea Kolsen Fischer 79 80 , Heli Harvala 81 82 , Kimberley S M Benschop 1
Affiliations
- PMID: 38547499
- DOI: 10.1093/infdis/jiae154
Enterovirus D68 (EV-D68) infections are associated with severe respiratory disease and acute flaccid myelitis (AFM). The European Non-Polio Enterovirus Network (ENPEN) aimed to investigate the epidemiological and genetic characteristics of EV-D68 and its clinical impact during the fall-winter season of 2021/22. From 19 European countries, 58 institutes reported 10,481 (6.8%) EV-positive samples of which 1,004 (9.6%) were identified as EV-D68 (852 respiratory samples). Clinical data was reported for 969 cases. 78.9% of infections were reported in children (0-5 years); 37.9% of cases were hospitalised. Acute respiratory distress was commonly noted (93.1%) followed by fever (49.4%). Neurological problems were observed in 6.4% of cases with six reported with AFM. Phylodynamic/Nextstrain and phylogenetic analyses based on 694 sequences showed the emergence of two novel B3-derived lineages, with no regional clustering. In conclusion, we describe a large-scale EV-D68 European upsurge with severe clinical impact and the emergence of B3-derived lineages.
Keywords: B3-derived lineages; European Non-Polio Enterovirus Network (ENPEN); acute flaccid myelitis (AFM); acute flaccid paralysis (AFP); coronavirus disease caused by SARS-CoV-2 (COVID-19); enterovirus D68 (EV-D68); non-polio enterovirus (NPEV); respiratory infection; surveillance.