Enhanced echovirus 11 genomic surveillance in neonatal infections in Spain following a European alert reveals new recombinant forms linked to severe cases, 2019 to 2023

BackgroundIn 2023, a European alert was issued regarding an increase in severe enterovirus (EV) neonatal infections associated with echovirus 11 (E11) new lineage 1.AimTo analyse E11-positive cases between 2019 and 2023 to investigate whether the new lineage 1 circulated in Spain causing severe neon...

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Published inEuro surveillance : bulletin européen sur les maladies transmissibles Vol. 29; no. 44; p. 1
Main Authors Fernandez-Garcia, Maria Dolores, Garcia-Ibañez, Nerea, Camacho, Juan, Gutierrez, Almudena, Sánchez García, Laura, Calvo, Cristina, Moreno-Docón, Antonio, Menasalvas, Ana Isabel, Medina, Antonio, Perez-Ruiz, Mercedes, Nieto Toboso, Maria Carmen, Muñoz-Almagro, Carmen, Launes, Cristian, Berengua, Carla, Cabrerizo, María
Format Journal Article
LanguageEnglish
Published Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 31.10.2024
European Centre for Disease Prevention and Control (ECDC)
Subjects
Adult
Child
Child, Preschool
Childrens health
Echovirus Infections - diagnosis
Echovirus Infections - epidemiology
Echovirus Infections - virology
Enterovirus B, Human - genetics
Enterovirus B, Human - isolation & purification
Female
Genome, Viral - genetics
Genomes
Genomics
Genotype
High-Throughput Nucleotide Sequencing
Humans
Infant
Infant, Newborn
Male
Neonatal care
Phylogeny
Spain - epidemiology
Surveillance
Spain
new variant
echovirus 11
recombinant
Enterovirus
neonatal infection
international alert
genomic surveillance
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Abstract BackgroundIn 2023, a European alert was issued regarding an increase in severe enterovirus (EV) neonatal infections associated with echovirus 11 (E11) new lineage 1.AimTo analyse E11-positive cases between 2019 and 2023 to investigate whether the new lineage 1 circulated in Spain causing severe neonatal infections.MethodsEV-positive samples from hospitalised cases are sent for typing to the National Reference Enterovirus Laboratory. Available samples from 2022-23 were subjected to metagenomic next-generation sequencing.ResultsOf 1,288 samples genotyped, 103 were E11-positive (98 patients: 6 adults, 33 neonates, 89 children under 6 years; male to female ratio 1.9). E11 detection rate was similar before and after detection of the new lineage 1 in Spain in June 2022 (9.7% in 2019 vs 10.6% in 2023). The proportion of E11-infected ICU-admitted neonates in 2019-2022 (2/7) vs 2022-2023 (5/12) did not significantly differ (p = 0.65). In severe neonatal infections, 4/7 E11 strains were not linked to the new lineage 1. The three novel E11 recombinant genomes were associated with severe (n = 2) and non-severe (n = 1) cases from 2022-2023 and clustered outside the new lineage 1. Coinfecting pathogenic viruses were present in four of 10 E11-positive samples.ConclusionThe emergence of the new lineage 1 is not linked with an increase in incidence or severity of neonatal E11 infections in Spain. The detection of two novel E11 recombinants associated with severe disease warrants enhancing genomic and clinical surveillance.
AbstractList Background In 2023, a European alert was issued regarding an increase in severe enterovirus (EV) neonatal infections associated with echovirus 11 (E11) new lineage 1. Aim To analyse E11-positive cases between 2019 and 2023 to investigate whether the new lineage 1 circulated in Spain causing severe neonatal infections. Methods EV-positive samples from hospitalised cases are sent for typing to the National Reference Enterovirus Laboratory. Available samples from 2022–23 were subjected to metagenomic next-generation sequencing. Results Of 1,288 samples genotyped, 103 were E11-positive (98 patients: 6 adults, 33 neonates, 89 children under 6 years; male to female ratio 1.9). E11 detection rate was similar before and after detection of the new lineage 1 in Spain in June 2022 (9.7% in 2019 vs 10.6% in 2023). The proportion of E11-infected ICU-admitted neonates in 2019–2022 (2/7) vs 2022–2023 (5/12) did not significantly differ (p = 0.65). In severe neonatal infections, 4/7 E11 strains were not linked to the new lineage 1. The three novel E11 recombinant genomes were associated with severe (n = 2) and non-severe (n = 1) cases from 2022–2023 and clustered outside the new lineage 1. Coinfecting pathogenic viruses were present in four of 10 E11-positive samples. Conclusion The emergence of the new lineage 1 is not linked with an increase in incidence or severity of neonatal E11 infections in Spain. The detection of two novel E11 recombinants associated with severe disease warrants enhancing genomic and clinical surveillance.
BackgroundIn 2023, a European alert was issued regarding an increase in severe enterovirus (EV) neonatal infections associated with echovirus 11 (E11) new lineage 1.AimTo analyse E11-positive cases between 2019 and 2023 to investigate whether the new lineage 1 circulated in Spain causing severe neonatal infections.MethodsEV-positive samples from hospitalised cases are sent for typing to the National Reference Enterovirus Laboratory. Available samples from 2022-23 were subjected to metagenomic next-generation sequencing.ResultsOf 1,288 samples genotyped, 103 were E11-positive (98 patients: 6 adults, 33 neonates, 89 children under 6 years; male to female ratio 1.9). E11 detection rate was similar before and after detection of the new lineage 1 in Spain in June 2022 (9.7% in 2019 vs 10.6% in 2023). The proportion of E11-infected ICU-admitted neonates in 2019-2022 (2/7) vs 2022-2023 (5/12) did not significantly differ (p = 0.65). In severe neonatal infections, 4/7 E11 strains were not linked to the new lineage 1. The three novel E11 recombinant genomes were associated with severe (n = 2) and non-severe (n = 1) cases from 2022-2023 and clustered outside the new lineage 1. Coinfecting pathogenic viruses were present in four of 10 E11-positive samples.ConclusionThe emergence of the new lineage 1 is not linked with an increase in incidence or severity of neonatal E11 infections in Spain. The detection of two novel E11 recombinants associated with severe disease warrants enhancing genomic and clinical surveillance.BackgroundIn 2023, a European alert was issued regarding an increase in severe enterovirus (EV) neonatal infections associated with echovirus 11 (E11) new lineage 1.AimTo analyse E11-positive cases between 2019 and 2023 to investigate whether the new lineage 1 circulated in Spain causing severe neonatal infections.MethodsEV-positive samples from hospitalised cases are sent for typing to the National Reference Enterovirus Laboratory. Available samples from 2022-23 were subjected to metagenomic next-generation sequencing.ResultsOf 1,288 samples genotyped, 103 were E11-positive (98 patients: 6 adults, 33 neonates, 89 children under 6 years; male to female ratio 1.9). E11 detection rate was similar before and after detection of the new lineage 1 in Spain in June 2022 (9.7% in 2019 vs 10.6% in 2023). The proportion of E11-infected ICU-admitted neonates in 2019-2022 (2/7) vs 2022-2023 (5/12) did not significantly differ (p = 0.65). In severe neonatal infections, 4/7 E11 strains were not linked to the new lineage 1. The three novel E11 recombinant genomes were associated with severe (n = 2) and non-severe (n = 1) cases from 2022-2023 and clustered outside the new lineage 1. Coinfecting pathogenic viruses were present in four of 10 E11-positive samples.ConclusionThe emergence of the new lineage 1 is not linked with an increase in incidence or severity of neonatal E11 infections in Spain. The detection of two novel E11 recombinants associated with severe disease warrants enhancing genomic and clinical surveillance.
BackgroundIn 2023, a European alert was issued regarding an increase in severe enterovirus (EV) neonatal infections associated with echovirus 11 (E11) new lineage 1.AimTo analyse E11-positive cases between 2019 and 2023 to investigate whether the new lineage 1 circulated in Spain causing severe neonatal infections.MethodsEV-positive samples from hospitalised cases are sent for typing to the National Reference Enterovirus Laboratory. Available samples from 2022-23 were subjected to metagenomic next-generation sequencing.ResultsOf 1,288 samples genotyped, 103 were E11-positive (98 patients: 6 adults, 33 neonates, 89 children under 6 years; male to female ratio 1.9). E11 detection rate was similar before and after detection of the new lineage 1 in Spain in June 2022 (9.7% in 2019 vs 10.6% in 2023). The proportion of E11-infected ICU-admitted neonates in 2019-2022 (2/7) vs 2022-2023 (5/12) did not significantly differ (p = 0.65). In severe neonatal infections, 4/7 E11 strains were not linked to the new lineage 1. The three novel E11 recombinant genomes were associated with severe (n = 2) and non-severe (n = 1) cases from 2022-2023 and clustered outside the new lineage 1. Coinfecting pathogenic viruses were present in four of 10 E11-positive samples.ConclusionThe emergence of the new lineage 1 is not linked with an increase in incidence or severity of neonatal E11 infections in Spain. The detection of two novel E11 recombinants associated with severe disease warrants enhancing genomic and clinical surveillance.
Author Medina, Antonio
Gutierrez, Almudena
Camacho, Juan
Launes, Cristian
Berengua, Carla
Nieto Toboso, Maria Carmen
Cabrerizo, María
Perez-Ruiz, Mercedes
Garcia-Ibañez, Nerea
Moreno-Docón, Antonio
Muñoz-Almagro, Carmen
Menasalvas, Ana Isabel
Fernandez-Garcia, Maria Dolores
Calvo, Cristina
Sánchez García, Laura
AuthorAffiliation The members of the study group are listed under Collaborators
AuthorAffiliation_xml – name: The members of the study group are listed under Collaborators
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  givenname: Maria Dolores
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  fullname: Fernandez-Garcia, Maria Dolores
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  surname: Garcia-Ibañez
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– sequence: 3
  givenname: Juan
  surname: Camacho
  fullname: Camacho, Juan
  organization: Enterovirus and Viral Gastroenteritis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
– sequence: 4
  givenname: Almudena
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  organization: IdiPaz Foundation, Translational Research Network in Pediatric Infectious Diseases, Hospital Universitario La Paz, Madrid, Spain
– sequence: 5
  givenname: Laura
  surname: Sánchez García
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  organization: IdiPaz Foundation, Translational Research Network in Pediatric Infectious Diseases, Hospital Universitario La Paz, Madrid, Spain
– sequence: 6
  givenname: Cristina
  surname: Calvo
  fullname: Calvo, Cristina
  organization: CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
– sequence: 7
  givenname: Antonio
  surname: Moreno-Docón
  fullname: Moreno-Docón, Antonio
  organization: Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia University, Murcia, Spain
– sequence: 8
  givenname: Ana Isabel
  surname: Menasalvas
  fullname: Menasalvas, Ana Isabel
  organization: Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia University, Murcia, Spain
– sequence: 9
  givenname: Antonio
  surname: Medina
  fullname: Medina, Antonio
  organization: Hospital Universitario Regional de Málaga, Málaga, Spain
– sequence: 10
  givenname: Mercedes
  surname: Perez-Ruiz
  fullname: Perez-Ruiz, Mercedes
  organization: Hospital Universitario Regional de Málaga, Málaga, Spain
– sequence: 11
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  surname: Nieto Toboso
  fullname: Nieto Toboso, Maria Carmen
  organization: Hospital Universitario de Basurto, Bilbao, Spain
– sequence: 12
  givenname: Carmen
  surname: Muñoz-Almagro
  fullname: Muñoz-Almagro, Carmen
  organization: Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
– sequence: 13
  givenname: Cristian
  surname: Launes
  fullname: Launes, Cristian
  organization: Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
– sequence: 14
  givenname: Carla
  surname: Berengua
  fullname: Berengua, Carla
  organization: Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
– sequence: 15
  givenname: María
  surname: Cabrerizo
  fullname: Cabrerizo, María
  organization: IdiPaz Foundation, Translational Research Network in Pediatric Infectious Diseases, Hospital Universitario La Paz, Madrid, Spain
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Copyright Copyright Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) Oct 31, 2024
This article is copyright of the authors or their affiliated institutions, 2024. 2024 The authors or their affiliated institutions
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Issue 44
Keywords new variant
echovirus 11
recombinant
Enterovirus
neonatal infection
international alert
genomic surveillance
Language English
License This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.
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Correspondence: Maria Dolores Fernandez-Garcia (mdfernandez@isciii.es)
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Snippet BackgroundIn 2023, a European alert was issued regarding an increase in severe enterovirus (EV) neonatal infections associated with echovirus 11 (E11) new...
Background In 2023, a European alert was issued regarding an increase in severe enterovirus (EV) neonatal infections associated with echovirus 11 (E11) new...
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StartPage 1
SubjectTerms Adult
Child
Child, Preschool
Childrens health
Echovirus Infections - diagnosis
Echovirus Infections - epidemiology
Echovirus Infections - virology
Enterovirus B, Human - genetics
Enterovirus B, Human - isolation & purification
Female
Genome, Viral - genetics
Genomes
Genomics
Genotype
High-Throughput Nucleotide Sequencing
Humans
Infant
Infant, Newborn
Male
Neonatal care
Phylogeny
Spain - epidemiology
Surveillance
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Title Enhanced echovirus 11 genomic surveillance in neonatal infections in Spain following a European alert reveals new recombinant forms linked to severe cases, 2019 to 2023
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