Enterovirus infections in England and Wales, 2000–2011: the impact of increased molecular diagnostics

• Published in: Clinical microbiology and infection Vol. 20; no. 12; pp. 1289 - 1296
• Main Authors: Kadambari, S., Bukasa, A., Okike, I.O., Pebody, R., Brown, D., Gallimore, C., Xerry, J., Sharland, M., Ladhani, S.N.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2014; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cell culture; Child; Child, Preschool; England - epidemiology; Enterovirus; Enterovirus Infections - diagnosis; Enterovirus Infections - epidemiology; Female; genotyping; Humans; Infant; Infant, Newborn; Male; Middle Aged; Molecular Diagnostic Techniques - methods; Molecular Diagnostic Techniques - utilization; Molecular Epidemiology - methods; Molecular Typing - methods; Molecular Typing - trends; Molecular Typing - utilization; PCR; surveillance; Wales - epidemiology; Young Adult; England; Wales; British Isles, England; British Isles, Wales; Cell culture; surveillance; enterovirus; PCR; genotyping
• DOI: 10.1111/1469-0691.12753
• ISSN: 1198-743X

There have recently been significant changes in diagnostic practices for detecting enterovirus (EV) infections across England and Wales. Reports of laboratory-confirmed EV infections submitted by National Health Service (NHS) hospital laboratories to Public Health England (PHE) over a 12-year period (2000–2011) were analysed. Additionally, the PHE Virus Reference Department (VRD) electronic database containing molecular typing data from 2004 onwards was interrogated. Of the 13 901 reports, there was a decline from a peak of 2254 in 2001 to 589 in 2006, and then an increase year-on-year to 1634 in 2011. This increase coincided with increasing PCR-based laboratory diagnosis, which accounted for 36% of reported cases in 2000 and 92% in 2011. The estimated annual incidence in 2011 was 3.9/100 000 overall and 238/100 000 in those aged <3 months, who accounted for almost one-quarter of reported cases (n = 2993, 23%). During 2004–2011, 2770 strains were submitted for molecular typing to the VRD, who found no evidence for a predominance of any particular strain. Thus, the recent increase in reported cases closely reflects the increase in PCR testing by NHS hospitals, but is associated with a lower proportion of samples being submitted for molecular typing. The high EV rate in young infants merits further investigation to inform evidence-based management guidance.