Epidemiological and Clinical Insights into the Enterovirus D68 Upsurge in Europe 2021–2022 and Emergence of Novel B3-Derived Lineages, ENPEN Multicentre Study
Margarida Simões, Emma B. Hodcroft, Peter Simmonds, Jan Albert, Enagnon Kazali Alidjinou, Katia Ambert‐Balay, Cristina Andrés, Andrés Antón, Christelle Auvray, Jean‐Luc Bailly, Fausto Baldanti, Capser Bastings, Stuart Beard, Carla Berengua, Nataša Berginc, Mandy Bloemen, Soile Blomqvist, Froukje Bosma, Sindy Böttcher, Laura Bubba, Stafan Buderus, María Cabrerizo, Cristina Calvo, Cristina Celma, Ferruccio Ceriotti, Gemma Clark, Inês Costa, Marianne Coste‐Burel, Karen Couderé, Jeroen Cremer, Margarita del Cuerpo Casas, Theo Daehne, Jessica de Beer, María de Ceano-Vivas, Cillian De Gascun, Alexis de Rougemont, Jonathan Dean, Jennifer L. Dembinski, Sabine Diedrich, Javier Díez‐Domingo, Lena Dillner, Dagny Haug Dorenberg, Alexandra Ducancelle, Susanne Dudman, Robert Dyrdak, Anna-Maria Eis-Huebinger, Iker Falces‐Romero, Ágnes Farkas, Susan Feeney, María Dolores Fernández-García, Jacky Flipse, Kristina Træholt Franck, Cristina Galli, Isabelle Garrigue, Felix Geeraedts, Irina Georgieva, Federica Giardina, Raquel Guiomar, Elenor Hauzenberger, E. Heikens, Cécille Henquell, Didier Hober, Mario Hönemann, Hannah C. Howson‐Wells, Željka Hruškar, Niina Ikonen, Berthe‐Marie Imbert, A Jansz, Marion Jeannoël, Helena Jiřincová, Laurence Josset, Kathrin Keeren, Naomie Kramer-Lindhout, Sidsel Krokstad, Mouna Lazrek, Hélène Le Guillou‐Guillemette, Caroline Lefeuvre, Andreas Lind, Maja M. Lunar, Melanie Maier, Stéphanie Marque‐Juillet, C. Patrick McClure, James McKenna, Adam Meijer, Ana Isabel Menasalvas, Beatriz Mengual‐Chuliá, Sofie Midgley, Audrey Mirand, Richard Molenkamp, Milagrosa Montes, Antonio Moreno‐Docón, Ursula Morley, Jean‐Luc Murk, Ana Navascués-Ortega, R.H.T. Nijhuis, Lubomira Nikolaeva–Glomb, Svein Arne Nordbø, Sanela Numanovic, Massimo Oggioni, Eider Oñate Vergara
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 infections and its clinical impact during the fall-winter season of 2021-2022. From 19 European countries, 58 institutes reported 10 481 (6.8%) EV-positive samples of which 1004 (9.6%) were identified as EV-D68 (including 852 respiratory samples). Clinical data were reported for 969 cases; 78.9% of infections were reported in children (0-5 years); and 37.9% of cases were hospitalized. Acute respiratory distress was commonly noted (93.1%) followed by fever (49.4%). Neurological problems were observed in 6.4% of cases including 6 diagnosed with AFM. Phylodynamic/Nextstrain and phylogenetic analyses based on 694 sequences showed the emergence of 2 novel B3-derived lineages, with no regional clustering. In conclusion, we describe a large-scale European EV-D68 upsurge with severe clinical impact and the emergence of B3-derived lineages.