Circulation of non-polio enteroviruses in 24 EU and EEA countries between 2015 and 2017: a retrospective surveillance study

Bubba, Laura; Broberg, Eeva; Jasir, Aftab; Simmonds, Peter; Harvala, Heli; Redlberger‐Fritz, Monika; Nikolaeva-Glomb, Lubomira; Havlíčková, Martina; Rainetová, Petra; Fischer, Thea Kølsen; Midgley, Sofie; Epštein, Jevgenia; Blomqvist, Soile; Böttcher, Sindy; Keeren, Kathrin; Bujaki, Erika; Farkas, Ágnes; Baldvinsdóttir, Guôrún Erna; Morley, Ursula; Gascun, Cillian De; Pellegrinelli, Laura; Piralla, Antonio; Martinuka, Oksana; Zamjatina, Natālija; Griskevicius, Algirdas; Nguyen, Trung; Dudman, Susanne; Numanovic, Sanela; Wieczorek, Magdalena; Guiomar, Raquel; Costa, Inês; Tecu, C; Bopegamage, Shubhada; Pastuchová, Katarína; Berginc, Nataša; Cabrerizo, María; González-Sanz, Rubén; Zakikhany, Katherina; Hauzenberger, Elenor; Benschop, Kimberley; Duizer, Erwin; Dunning, Jake; Celma, Cristina; McKenna, James; Feeney, Susan; Templeton, Kate; Moore, D. J.; Cottrell, Simon

doi:10.1016/s1473-3099(19)30566-3

Cited by 113 publications

(130 citation statements)

References 30 publications

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“…Enteroviruses were detected year-round in this study. Consistent with the seasonality of EV infections in temperate climates, we have shown that EV-associated infections of the CNS were more prevalent during the summer-fall season [ 26 , 48 , 49 , 50 , 51 ]. We have also noted small differences in the peak months by different EV types.…”

Section: Discussionsupporting

confidence: 70%

Pediatric Enteroviral Central Nervous System Infections in Bialystok, Poland: Epidemiology, Viral Types, and Drivers of Seasonal Variation

Toczyłowski

Wieczorek

Bojkiewicz

et al. 2020

Viruses

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Enteroviruses are common causes of infections of the central nervous system (CNS) that in temperate climates tend to peak in the summer. The aim of the study was to describe epidemiology, drivers of seasonality, and types of enteroviruses causing infections of the CNS in children in Northeastern Poland. We prospectively collected data on children hospitalized with infection of the CNS attributed to enteroviruses in Bialystok, Poland, from January 2015 to December 2019. In total, 224 children were included. Nineteen different enterovirus types were identified in isolates collected from 188 children. Coxsackie B5 (32%), echovirus 30 (20%), and echovirus 6 (14%) were the three most common types. Enteroviruses were more prevalent during the summer–fall season. Infections caused by echovirus 30 peaked early in June and coxsackievirus B5 in July, whereas echovirus 6 peaked late in October. Phylogenetic analyses of these three enterovirus types showed multiple lineages co-circulating in this region. Mean air temperatures and precipitation rates were independently associated with monthly number of cases. Considering lack of effective treatment or vaccine, easy transmission of enteroviruses between susceptible individuals, their high mutation rate and prolonged time of viral shedding, continued monitoring and surveillance are imperative to recognize enteroviral infections of the CNS and the changes in circulation of enteroviruses in Poland.

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Section: Discussionsupporting

confidence: 70%

Pediatric Enteroviral Central Nervous System Infections in Bialystok, Poland: Epidemiology, Viral Types, and Drivers of Seasonal Variation

Toczyłowski

Wieczorek

Bojkiewicz

et al. 2020

Viruses

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“…A study by the European Centre for Disease Control collected data from 24 European countries on non-polio EVs detected during a 3-year study period revealed 66 types of EVs of which 16 types were also detected in Hungary [34]. The most frequently reported enterovirus type between 2015-2017 in both studies was CVA6, representing 13% of typed EVs in Europe and 59% of detected EV infections in Hungary.…”

Section: Discussionmentioning

confidence: 99%

“…In an Amsterdam hospital (2007-2011) five echoviruses E-30, E-25, E-6, E-9 and E-7 ranked among the top 10 types found overall [38]. Echoviruses were also among the types detected most frequently as part of hospital-based enterovirus surveillances in France (2000)(2001)(2002)(2003)(2004) and the USA [33,34]. E-30, E-9, and E-6 followed the predominant E-4 in a study that investigated the etiology of aseptic meningitis and infant febrile syndromes in 2008 in Spain, [42].…”

Section: Discussionmentioning

confidence: 99%

Distribution of enterovirus genotypes detected in clinical samples in Hungary, 2010–2018

Bujaki

Farkas

Rigó

et al. 2020

AMicr

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This report provides the findings of a retrospective surveillance study on the emergence and circulation of enteroviruses with their associated clinical symptoms over a nine-year period detected at the National Enterovirus Reference Laboratory in Hungary between 2010–2018.Enterovirus (EV) detection and genotyping were performed directly from clinical samples. From 4,080 clinical specimens 25 EV types were identified with a median age of patients of 5 years and 68% of all cases affected children aged 10 years or younger, although infections occurred in all age-groups. In 130 cases neurological symptoms were recorded, in 123 cases the infection presented in skin related signs including hand, foot, and mouth disease (HFMD), herpangina and rash. In 2010 EV-A71 was found to cause the majority of diagnosed EV infections while in 2011 and from 2014–2018, Coxsackievirus (CV)-A6 was identified most often. Echovirus E6 accounted for the most cases in 2012 and Echovirus 30 dominated in 2013. EV-D68 was identified only in 2010 and 2013.Widespread circulation of several EV-A and EV-B viruses with occasional occurrence of EV-C and EV-D was detected. The ability of EVs to cause severe infections in sporadic cases and regular outbreaks highlight the importance of continued monitoring of circulating EV types.

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“…However, CVB-associated HFMD incidence increased from 3% in 2010 to 17.1% in 2011 [86,91], which may explain increased T1D incidence. Europe does not currently have a virus surveillance program in place, but does have widespread circulation of over 30 different enteroviruses including diabetes-associated viruses CVB and echovirus [92]. Fortunately, the Center for Disease Control and Prevention (CDC) has developed the national enterovirus surveillance system to monitor the detection of enteroviruses and parechoviruses in the United States [93].…”

Section: Enteroviruses and Their Association With T1dmentioning

confidence: 99%

Innate Viral Sensor MDA5 and Coxsackievirus Interplay in Type 1 Diabetes Development

Blum¹,

Tse²

2020

Microorganisms

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Type 1 diabetes (T1D) is a polygenic autoimmune disease characterized by immune-mediated destruction of insulin-producing β-cells. The concordance rate for T1D in monozygotic twins is ≈30–50%, indicating that environmental factors also play a role in T1D development. Previous studies have demonstrated that enterovirus infections such as coxsackievirus type B (CVB) are associated with triggering T1D. Prior to autoantibody development in T1D, viral RNA and antibodies against CVB can be detected within the blood, stool, and pancreata. An innate pathogen recognition receptor, melanoma differentiation-associated protein 5 (MDA5), which is encoded by the IFIH1 gene, has been associated with T1D onset. It is unclear how single nucleotide polymorphisms in IFIH1 alter the structure and function of MDA5 that may lead to exacerbated antiviral responses contributing to increased T1D-susceptibility. Binding of viral dsRNA via MDA5 induces synthesis of antiviral proteins such as interferon-alpha and -beta (IFN-α/β). Viral infection and subsequent IFN-α/β synthesis can lead to ER stress within insulin-producing β-cells causing neo-epitope generation, activation of β-cell-specific autoreactive T cells, and β-cell destruction. Therefore, an interplay between genetics, enteroviral infections, and antiviral responses may be critical for T1D development.

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Circulation of non-polio enteroviruses in 24 EU and EEA countries between 2015 and 2017: a retrospective surveillance study

Cited by 113 publications

References 30 publications

Pediatric Enteroviral Central Nervous System Infections in Bialystok, Poland: Epidemiology, Viral Types, and Drivers of Seasonal Variation

Pediatric Enteroviral Central Nervous System Infections in Bialystok, Poland: Epidemiology, Viral Types, and Drivers of Seasonal Variation

Distribution of enterovirus genotypes detected in clinical samples in Hungary, 2010–2018

Innate Viral Sensor MDA5 and Coxsackievirus Interplay in Type 1 Diabetes Development

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