Enterovirus D68-associated respiratory and neurological illness in Spain, 2014–2018

Abstract

During 2014, enterovirus D68 (EV-D68) outbreaks were described globally, causing severe respiratory diseases in children and, in some cases, subsequent paralysis. In this study, the type characterization of enterovirus (EV) detected in respiratory illnesses and the epidemiology and clinical association of EV-D68 infections in Spain over a five-year period were described. A total of 546 EV-positive samples from hospitalized patients with respiratory infections were included. EV-D68 was the most frequently detected type (46.6%, 191/410 typed EV). Other EV from species A (25.1%), B (27.8%) and C (0.5%) were also identified. EV-D68 infections were more associated with bronchitis while EV-A/B types were more frequent in upper respiratory illness (p < 0.01). EV-D68 was also detected in patients with neurological symptoms (nine meningitis/meningoencephalitis and eight acute flaccid paralysis cases). Phylogenetic analysis of 3′-VP1 region showed most Spanish EV-D68 sequences from 2014 to 2016 belonged to subclades B2/B3, as other American and European strains circulating during the same period. However, those detected in 2017 and 2018 clustered to the emerged subclade D1. In summary, different EV can cause respiratory infections but EV-D68 was the most prevalent, with several strains circulating in Spain at least since 2014. Association between EV-D68 infection and neurological disease was also described.

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

“…Since 2014, a growing number of enterovirus D68 outbreaks associated with severe respiratory diseases and neurological complications have been occurring in different countries. Enterovirus D68 has also been detected in children with aseptic meningitis [ 23 ]. We did not use primers to detect VP1 sequences of EV-D species.…”

Viral meningitis: an overview

“…Enterovirus D68 (EV-D68) is the most common member of the species Enterovirus D found to be associated with the development of aseptic meningitis. EV-D68 can cause CNS complications in children, commonly meningitis and flaccid paralysis [ 72 ]. The pathogenesis of EV-D68 is quite different from that of other enteroviruses, since it is a respiratory virus.…”

Das neue Verständnis pulmonaler Infektionen

“…Based on the fundamental knowledge on the spectrum of pathogens of communityacquired and nosocomial lung infections, novel approaches in pathogen diagnostics and lung microbiome analytics are discussed and the applicability with respect to the current clinical routine is questioned. 10,[4][5][6][7][8][9][10][11]3 Tagen in beiden Gruppen und fehlende konkrete Handlungsanweisungen, wie im Fall eines Virusnachweises zu verfahren ist [26]. In einer anderen Arbeit von Shengchen et al konnte hingegen eine Reduktion der stationären Verweildauer und der Therapiedauer mit einem Antibiotikum um jeweils 1 Tag unter Verwendung eines Multiplex-PCR-Verfahrens als "point-of-care-testing" (POCT) im Vergleich zu klassischen Routinetestungen gezeigt werden [28].…”