Epidemiological and clinical insights into the enterovirus D68 upsurge in Europe 2021/22 and the emergence of novel B3-derived lineages, ENPEN multicentre study

• Published in: The Journal of infectious diseases
• Main Authors: Simoes, Margarida Pires, Hodcroft, Emma, Simmonds, Peter, Albert, Jan, Alidjinou, Enagon, Ambert-Balay, Katia, Andrés, Cristina, Antón, Andrés, Auvray, Christelle, Bailly, Jean-Luc, Baldanti, Fausto, Bastings, Capser, Beard, Stuart, Pereira, Carla Berengua, Berginc, Natasa, Bloemen, Mandy, Blomqvist, Soile, Bosma, Froukje, Böttcher, Sindy, Bubba, Laura, Buderus, Stafan, Cabrerizo, Maria, Calvo, Christina, Celma, Christina, Ceriotti, Ferruccio, Clark, Gemma, Costa, Inës, Coste-Burel, Marianne, Couderé, Karen, Cremer, Jeroen, del Cuerpo Casas, Margarita, Daehne, Theo, de Beer, Jessica, de Ceano-Vivas, Maria, de Gascun, Cillian, de Rougemont, Alexis, Dean, Johnathan, Dembinski, Jennifer, Diedrich, Sabine, Diez-Domingo, Javier, Dillner, Lena, Dorenberg, Dagny, Ducancelle, Alexandra, Dudman, Susanne, Dyrdak, Robert, Eis-Huebinger, Anna-Maria, Falces-Romero, Iker, Farkas, Agnes, Feeney, Susan, Fernandez-Garcia, Maria, Flipse, Jacky, Franck, Kristina, Galli, Cristina, Garrigue, Isabelle, Geeraedts, Felix, Georgieva, Irina, Giardina, Federica, Guiomar, Raquel, Hauzenberger, Elenor, Heikens, Esther, Henquell, Cécille, Hober, Didier, Hönemann, Amrio, Howson-Wells, Hannah, Hruškar, Željka, Ikonen, Niina, Imbert, Berthemarie, Jansz, Arjan, Jeannoël, Marion, Jiřincová, Helena, Josset, Laurence, Keeren, Kathrin, Kramer-Lindhout, Naomie, Krokstad, Sidsel, Lazrek, Mouna, Le Guillou-Guillemette, Hélène, Lefeuvre, Caroline, Lind, Andreas, Lunar, Maja, Maier, Melanie, Marque-Juillet, Stéphanie, Mcclure, C Patrick, Mckenna, James, Meijer, Adam, Menasalvas Ruiz, Ana, Mengual-Chuliá, Beatriz, Midgley, Sofie, Mirand, Audrey, Molenkamp, Richard, Montes, Milagrosa, Moreno-Docón, Antonio, Morley, Ursula, Murk, Jean-Luc, Navascués-Ortega, Ana, Nijhuis, Roel, Nikolaeva-Glomb, Lubomira, Nordbø, Svein, Numanovic, Sanela, Oggioni, Massimo, Oñate Vergara, Eider
• Format: Journal Article
• Language: English
• Published: Oxford University Press 2024
• Subjects: Emerging diseases; Human health and pathology; Infectious diseases; Life Sciences; Microbiology and Parasitology; Santé publique et épidémiologie; Virology; acute flaccid paralysis (AFP); European Non-Polio Enterovirus Network (ENPEN); enterovirus D68 (EV-D68); B3-derived lineages; respiratory infection; acute flaccid myelitis (AFM); surveillance; coronavirus disease caused by SARS-CoV-2 (COVID-19); non-polio enterovirus (NPEV)
• ISSN: 0022-1899; 1537-6613
• 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.