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J Infect Dis . Epidemiological and clinical insights into the enterovirus D68 upsurge in Europe 2021/22 and the emergence of novel B3-derived linea

tetano

Editor, Senior Moderator
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[SUP] 1 2 [/SUP], Emma B Hodcroft[SUP] 3 4 5 [/SUP], Peter Simmonds[SUP] 6 [/SUP], Jan Albert[SUP] 7 8 [/SUP], Enagon K Alidjinou[SUP] 9 [/SUP], Katia Ambert-Balay[SUP] 10 [/SUP], Cristina Andrés[SUP] 11 [/SUP], Andrés Antón[SUP] 11 [/SUP], Christelle Auvray[SUP] 10 [/SUP], Jean-Luc Bailly[SUP] 12 [/SUP], Fausto Baldanti[SUP] 13 14 [/SUP], Capser Bastings[SUP] 15 [/SUP], Stuart Beard[SUP] 16 [/SUP], Carla Berengua Pereira[SUP] 17 [/SUP], Natasa Berginc[SUP] 18 [/SUP], Mandy Bloemen[SUP] 19 [/SUP], Soile Blomqvist[SUP] 20 [/SUP], Froukje Bosma[SUP] 21 [/SUP], Sindy Böttcher[SUP] 22 [/SUP], Laura Bubba[SUP] 23 [/SUP], Stafan Buderus[SUP] 24 [/SUP], Maria Cabrerizo[SUP] 25 [/SUP], Christina Calvo[SUP] 26 [/SUP], Christina Celma[SUP] 16 [/SUP], Ferruccio Ceriotti[SUP] 27 [/SUP], Gemma Clark[SUP] 28 [/SUP], Inës Costa[SUP] 29 [/SUP], Marianne Coste-Burel[SUP] 30 [/SUP], Karen Couderé[SUP] 31 [/SUP], Jeroen Cremer[SUP] 1 [/SUP], Margarita Del Cuerpo Casas[SUP] 17 [/SUP], Theo Daehne[SUP] 32 [/SUP], Jessica de Beer[SUP] 21 [/SUP], Maria de Ceano-Vivas[SUP] 26 [/SUP], Cillian De Gascun[SUP] 33 [/SUP], Alexis de Rougemont[SUP] 10 [/SUP], Johnathan Dean[SUP] 33 [/SUP], Jennifer L Dembinski[SUP] 34 [/SUP], Sabine Diedrich[SUP] 22 [/SUP], Javier Diez-Domingo[SUP] 35 [/SUP], Lena Dillner[SUP] 36 [/SUP], Dagny H Dorenberg[SUP] 34 [/SUP], Alexandra Ducancelle[SUP] 37 [/SUP], Susanne Dudman[SUP] 38 39 [/SUP], Robert Dyrdak[SUP] 7 8 [/SUP], Anna-Maria Eis-Huebinger[SUP] 40 [/SUP], Iker Falces-Romero[SUP] 41 [/SUP], Agnes Farkas[SUP] 42 [/SUP], Susan Feeney[SUP] 43 [/SUP], Maria D Fernandez-Garcia[SUP] 44 [/SUP], Jacky Flipse[SUP] 45 [/SUP], Kristina T Franck[SUP] 46 [/SUP], Cristina Galli[SUP] 47 [/SUP], Isabelle Garrigue[SUP] 48 [/SUP], Felix Geeraedts[SUP] 21 [/SUP], Irina Georgieva[SUP] 49 [/SUP], Federica Giardina[SUP] 13 [/SUP], Raquel Guiomar[SUP] 29 [/SUP], Elenor Hauzenberger[SUP] 36 [/SUP], Esther Heikens[SUP] 50 [/SUP], Cécille Henquell[SUP] 51 [/SUP], Didier Hober[SUP] 9 [/SUP], Amrio Hönemann[SUP] 52 [/SUP], Hannah Howson-Wells[SUP] 28 [/SUP], Željka Hruškar[SUP] 53 [/SUP], Niina Ikonen[SUP] 20 [/SUP], Berthemarie Imbert[SUP] 30 [/SUP], Arjan R Jansz[SUP] 15 [/SUP], Marion Jeannoël[SUP] 54 [/SUP], Helena Jiřincová[SUP] 55 [/SUP], Laurence Josset[SUP] 54 [/SUP], Kathrin Keeren[SUP] 56 [/SUP], Naomie Kramer-Lindhout[SUP] 57 [/SUP], Sidsel Krokstad[SUP] 58 [/SUP], Mouna Lazrek[SUP] 9 [/SUP], Hélène Le Guillou-Guillemette[SUP] 37 [/SUP], Caroline Lefeuvre[SUP] 37 [/SUP], Andreas Lind[SUP] 38 [/SUP], Maja M Lunar[SUP] 59 [/SUP], Melanie Maier[SUP] 52 [/SUP], Stéphanie Marque-Juillet[SUP] 60 [/SUP], C Patrick McClure[SUP] 28 61 [/SUP], James McKenna[SUP] 43 [/SUP], Adam Meijer[SUP] 1 [/SUP], Ana Menasalvas Ruiz[SUP] 62 [/SUP], Beatriz Mengual-Chuliá[SUP] 35 [/SUP], Sofie Midgley[SUP] 46 [/SUP], Audrey Mirand[SUP] 12 51 [/SUP], Richard Molenkamp[SUP] 63 [/SUP], Milagrosa Montes[SUP] 64 [/SUP], Antonio Moreno-Docón[SUP] 65 [/SUP], Ursula Morley[SUP] 33 [/SUP], Jean-Luc Murk[SUP] 31 [/SUP], Ana Navascués-Ortega[SUP] 66 [/SUP], Roel Nijhuis[SUP] 67 [/SUP], Lubomira Nikolaeva-Glomb[SUP] 49 [/SUP], Svein A Nordbø[SUP] 68 [/SUP], Sanela Numanovic[SUP] 34 [/SUP], Massimo Oggioni[SUP] 69 [/SUP], Eider Oñate Vergara[SUP] 64 [/SUP], Jordi Pacaud[SUP] 48 [/SUP], Marie L Pacreau[SUP] 60 [/SUP], Marcus Panning[SUP] 32 [/SUP], Elena Pariani[SUP] 47 [/SUP], Lili Pekova[SUP] 70 [/SUP], Laura Pellegrinelli[SUP] 47 [/SUP], Miroslav Petrovec[SUP] 71 [/SUP], Corinna Pietsch[SUP] 52 [/SUP], Léa Pilorge[SUP] 72 [/SUP], Luis Piñeiro[SUP] 64 [/SUP], Antonio Piralla[SUP] 13 [/SUP], Mario Poljak[SUP] 59 [/SUP], Birgit Prochazka[SUP] 73 [/SUP], Nuria Rabella[SUP] 17 [/SUP], Janette C Rahamat-Langendoen[SUP] 63 [/SUP], Petra Rainetova[SUP] 55 [/SUP], Marijke Reynders[SUP] 74 [/SUP], Annelies Riezebos-Brilman[SUP] 21 [/SUP], Lieuwe Roorda[SUP] 75 [/SUP], Carita Savolainen-Kopra[SUP] 20 [/SUP], Isabelle Schuffenecker[SUP] 54 [/SUP], Leo C Smeets[SUP] 76 [/SUP], Ayse Stoyanova[SUP] 49 [/SUP], Karl Stefic[SUP] 77 [/SUP], Caroline Swanink[SUP] 45 [/SUP], Irena Tabain[SUP] 53 [/SUP], Jeroen Tjhie[SUP] 15 31 [/SUP], Luc Thouault[SUP] 72 [/SUP], Camille Tumiotto[SUP] 48 [/SUP], Sara Uceda Renteria[SUP] 27 [/SUP], Tina Uršič[SUP] 71 [/SUP], Sophie Vallet[SUP] 72 [/SUP], Marc Van Ranst[SUP] 19 [/SUP], Peter Van Wunnik[SUP] 76 [/SUP], Jaco J Verweij[SUP] 31 [/SUP], Jorgina Vila[SUP] 11 [/SUP], Bas Wintermans[SUP] 57 [/SUP], Elke Wollants[SUP] 19 [/SUP], Katja C Wolthers[SUP] 78 [/SUP], F Xavier López-Labrado[SUP] 35 [/SUP], Thea Kolsen Fischer[SUP] 79 80 [/SUP], Heli Harvala[SUP] 81 82 [/SUP], Kimberley S M Benschop[SUP] 1 [/SUP]



Affiliations
Abstract

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.

 
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