Outbreak of enterovirus D68 of the new B3 lineage in Stockholm, Sweden, August to September 2016

Dyrdak, Robert; Grabbe, Malin; Hammas, Berit; Ekwall, Jonas; Hansson, K.; Luthander, Joachim; Nauclér, Pontus; Reinius, Henrik; Rotzén-Östlund, Maria; Albert, Jan

doi:10.2807/1560-7917.es.2016.21.46.30403

Cited by 81 publications

(77 citation statements)

References 9 publications

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“…By contrast, EV from species A or B were more frequently detected in upper respiratory tract infections (p < 0.01). Also, there was no significant difference in the proportion of patients from each group admitted to the ICU in contrast to those reported by other authors who observed a higher incidence of severe disease among patients infected by EV-D68 [33,35].…”

Section: Discussioncontrasting

confidence: 91%

“…The phylogenetic tree showed that most of the Spanish EV-D68 sequences detected during 2016 clustered to the recently described lineage B3 [33], while strains from 2014 and 2015 belonged to subclade B2. Similar results have been obtained with other studies [34,35], suggesting that all the 2016 outbreaks would be [28][29][30]. These findings indicate that although EV-D68 epidemics can be due to the emergence of new lineages, multiple clades have been circulating simultaneously worldwide from 2010 to the present day.…”

Section: Discussionsupporting

confidence: 90%

“…In 2016 and 2018, however, it circulated almost throughout the year, with a higher incidence in spring and summer. This seasonal distribution, in which EV-D68 has periods of low circulation followed by others with high incidence, has been reported in other countries [29,30,[33][34][35], and suggest epidemics of EV-D68 in 2016 and 2018, which was confirmed by phylogenetic analyses of partial VP1 sequences showing increased genetic diversity. The phylogenetic tree showed that most of the Spanish EV-D68 sequences detected during 2016 clustered to the recently described lineage B3 [33], while strains from 2014 and 2015 belonged to subclade B2.…”

Section: Discussionsupporting

confidence: 81%

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

González-Sanz

Taravillo

Reina

et al. 2019

Emerging Microbes & Infections

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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.

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Section: Discussioncontrasting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 81%

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

González-Sanz

Taravillo

Reina

et al. 2019

Emerging Microbes & Infections

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“…During the 2014 EV-D68 epidemic in Europe, most of the 205 sequenced viruses collected in 17 countries in the second semester of the year were found to belong to B1 and B2 clades, whereas A clades, although co-circulating, were detected in a smaller number of patients [31]. Since April 2016, EV-D68 infection outbreaks have been reported in several European countries, particularly in Northern Europe [31][32][33]. Phylogenetic analyses showed that these viruses belonged to the B3 lineage [32].…”

Section: Discussionmentioning

confidence: 99%

Enterovirus-D68 (EV-D68) in pediatric patients with respiratory infection: The circulation of a new B3 clade in Italy

Piralla

Principi

Ruggiero

et al. 2018

Journal of Clinical Virology

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“…Between 1970 and 2005, only 26 cases were reported to the CDC and the virus was generally associated with mild upper respiratory illness [8,9].In 2014, unprecedented outbreaks of EV-D68 associated with severe respiratory disease and acute flaccid myelitis emerged throughout the world [3,. Since 2014, there have been biannual patterns of severe disease associated with EV-D68 [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. This unique pattern of recurring outbreaks and severe pathology sheds light on the importance of understanding evolutionary changes in contemporary EV-D68 strains.…”

Section: Introductionmentioning

confidence: 99%

Contemporary Enterovirus D68 strains show enhanced replication and translation at 37°C

Smith

Pekosz

2020

Preprint

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Enterovirus D68 (EV-D68) emerged in 2014 as an important pathogen linked to severe lower respiratory disease and acute flaccid myelitis outbreaks. Historically associated with mild common-cold-like symptoms, clusters of severe disease attributed to EV-D68 appeared during a series of outbreaks in 2014, 2016, and 2018. Previous studies of historic EV-D68 strains demonstrated attenuated replication at temperatures of the lower respiratory tract (37°C), when compared to the upper respiratory tract (32°C). By testing a panel of historic and contemporary EV-D68 strains at 32°C and 37°C, we demonstrate that contemporary strains of EV-D68 undergo little to no attenuation at increased temperatures. Contemporary strains produced higher levels of viral proteins at 32°C and 37°C than historic strains, although both strains infected similar numbers of cells and had comparable amounts of replication complexes. IRES activity assays with dual-luciferase reporter plasmids demonstrated enhanced translation in recent EV-D68 strains mapped to regions of variability in the 5' UTR found only in contemporary strains. Using an infectious clone system, we demonstrate that the translation advantage dictated by the 5' UTR does not solely mediate temperature sensitivity. The strain-dependent effects of temperature on the EV-D68 life cycle gives insight into the susceptibility of the lower respiratory system to contemporary strains. IMPORTANCEEnterovirus-D68 (EV-D68) emerged in 2014 as a causative agent of biannual severe pediatric respiratory disease and acute flaccid myelitis (AFM). We show that recent EV-D68 viruses have gained the ability to replicate at 37⁰C. Enhanced virus protein translation seemed to correlate with enhanced virus replication at 37⁰C but other genetic factors are also contributing to this phenotype. An enhanced ability to replicate at core body temperature may have allowed EV-D68 to penetrate both lower in the respiratory tract and into the central nervous system, explaining the recent surge in severe disease associated with virus infection.

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Outbreak of enterovirus D68 of the new B3 lineage in Stockholm, Sweden, August to September 2016

Cited by 81 publications

References 9 publications

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

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

Enterovirus-D68 (EV-D68) in pediatric patients with respiratory infection: The circulation of a new B3 clade in Italy

Contemporary Enterovirus D68 strains show enhanced replication and translation at 37°C

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