European surveillance for enterovirus D68 during the emerging North-American outbreak in 2014

J Clin Virol. 2015 Oct;71:1-9. doi: 10.1016/j.jcv.2015.07.296. Epub 2015 Jul 26.

Abstract

Background: In August and September 2014, unexpected clusters of enterovirus-D68 (EV-D68) infections associated with severe respiratory disease emerged from North-America. In September, the European Centre for Disease Prevention and Control (ECDC) asked European countries to strengthen respiratory sample screening for enterovirus detection and typing in cases with severe respiratory presentations.

Objectives: To provide a detailed picture of EV-D68 epidemiology in Europe by conducting a retrospective and prospective laboratory analysis of clinical specimens.

Study design: An initiative supported by the European Society for Clinical Virology (ESCV) and ECDC was launched to screen for EV-D68 in respiratory specimens between July 1st and December 1st 2014 in Europe and to sequence the VP1 region of detected viruses for phylogenetic analytic purposes.

Results: Forty-two institutes, representing 51 laboratories from 17 European countries, analyzed 17,248 specimens yielding 389 EV-D68 positive samples (2.26%) in 14 countries. The proportion of positive samples ranged between 0 and 25% per country. These infections resulted primarily in mild respiratory disease, mainly detected in young children presenting with wheezing and in immuno-compromised adults. The viruses detected in Europe are genetically very similar to those of the North-American epidemic and the majority (83%) could be assigned to clade B. Except for 3 acute flaccid paralysis (AFP) cases, one death and limited ICU admissions, no severe cases were reported.

Conclusions: The European study showed that EV-D68 circulated in Europe during summer and fall of 2014 with a moderate disease burden and different pathogenic profile compared to the North-American epidemic.

Keywords: Enterovirus D68; Molecular epidemiology; Respiratory infection; VP1 sequencing.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Disease Outbreaks*
  • Enterovirus D, Human / isolation & purification*
  • Enterovirus Infections / epidemiology*
  • Enterovirus Infections / pathology
  • Enterovirus Infections / virology*
  • Epidemiological Monitoring
  • Europe / epidemiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Molecular Epidemiology
  • Molecular Typing
  • North America / epidemiology
  • Prospective Studies
  • Retrospective Studies
  • Sequence Analysis, DNA
  • Viral Structural Proteins / genetics
  • Young Adult

Substances

  • Viral Structural Proteins