Epidemiological and clinical insights into enterovirus circulation in Europe, 2018 - 2023: a multi-center retrospective surveillance study
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de Schrijver, Sten | Vanhulle, Emiel | Ingenbleek, Anne | Alexakis, Leonidas | Johannesen, Caroline Klint | Broberg, Eeva | Harvala, Heli | Fischer, Thea | Benschop, Kimberley | Albert, Jan | Allen, Nancy | Andreoletti, Laurent | Atabani, Sowsan | Auvray, Christelle | Bart, Aldert | Berengua, Carla | Berginc, Natasa | Bisseux, Maxime | Boon, Hanneke | Bordes-Benitez, Ana | Bosworth, Andrew | Böttcher, Sindy | Cabrerizo, Maria | Callegaro, Annapaola | Calvo, Cristina | Canning, Benjamin | Coste-Burel, Marianne | Couderé, Karen | Delarbre, Jean-Marie | Diedrich, Sabine | Dudman, Susanne | Dyrdak, Robert | Exinger, Julien | Farfour, Eric | Fernandez-Garcia, Maria Dolores | Flipse, Jacky | Foulongne, Vincent | Franck, Kristina Træholt | Gallais, Floriane | Garcia, Magali | Georgieva, Irina | Gonfrier, Géraldine | Guillaume, Clémence | Gutierrez-Arroyo, Almudena | Henquell, Cécile | Hooghiemstra, Marijke | Huijskens, Elisabeth | Jääskeläinen, Anne | Jeannoël, Marion | Jourdain, Marine | Landaas, Elisabeth Toverud | Keeren, Kathrin | Lagarejos, Eduardo | Lagathu, Gisèle | Larrat, Sylvie | Launes, Cristian | Lazrek, Mouna | Lefeuvre, Caroline | Lemée, Véronique | Lepiller, Quentin | Leruez, Marianne | Leyssene, David | L'Honneur, Anne Sophie | Lina, Bruno | Ducoroy, Marie Louchet | Lunar, Maja | Mansuy, Jean-Michel | Julliet, Stéphanie Marque | Mcallister, Gina | Mcclure, C Patrick | Medina-Claros, Antonio | Megias, Gregoria | Midgley, Sofie Elisabeth | Mirand, Audrey | Molenkamp, Richard | Montes, Milagrosa | Moreno-Docón, Antonio | Munoz-Almagro, Carmen | Murat, Jean-Benjamin | Murk, Jean-Luc | Navascues-Ortega, Ana | Nieto-Toboso, Maria Carmen | Ninove, Laetitia | Oosting, Marije | Oñate, Eider | Pacaud, Jordi | Pallier, Coralie | Pariani, Elena | Pellegrinelli, Laura | Pérez-Ruiz, Mercedes | Pillet, Sylvie | Pilorgé, Léa | Piñeiro, Luis | Poljak, Mario | Prochazka, Birgit | Riverain, Emeline | Rogez, Sylvie | Salmona, Maud | Saloum, Kenda | Schaftenaar, Erik | Schanen, Cécile | Schibler, Manuel | Schuffenecker, Isabelle | Stefic, Karl | Susi, Petri | Swanink, Caroline | Tellini, Charlotte | Toyer, Anne Lise | Renteria, Sara Colonia Uceda | Valencia-Ramos, Juan | van Loenen, Freek | van Loo, Inge | Venard, Véronique | Verweij, Jaco | von Eije, Karin | Vuorinen, Tytti | Wollants, Elke | Zanetti, Laura
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CCSD ; Oxford University Press -
International audience.
Abstract Background Enteroviruses (EV) cause yearly outbreaks with severe infections, particularly in young children. This study investigates EV circulation, age-distribution, and clinical presentations in Europe from 2018-2023. Methods Aggregated data were requested from ECDC National Focal Points for Surveillance and European Non-Polio Enterovirus Network. Data included detection month, specimen type, age-group, and clinical presentation for the ten most commonly reported EV types per year. Findings Twenty-eight institutions from 16 countries reported 563,654 EV-tests during the study-period with 33,265 (5.9%) EV-positive. Forty-two types were identified (n=11,605 cases) with echovirus (E)30, coxsackievirus (CV)A6, EV-D68, E9, E11, CVB5, E18, CVB4, EV-A71, and E6 most frequently reported. E30 detection declined after 2018/2019, while CVA6, CVB5, E9, E11, and EV-D68 were prevalent both before and after the COVID-19 pandemic, and CVB4 and E18 were prevalent after the pandemic. Over the study period, a shift in seasons (summer to fall) and specimen positivity (feces to respiratory) was observed. Neurological signs predominated among EV-A71, CVB4, CVB5, E6, E9, E11, E18, and E30 (30-72%). CVB4, CVB5, E9, E11, and E18 were also frequently reported among neonates (18-32%). CVA6 was frequently associated with HFMD, and EV-D68 with respiratory infections. Paralysis was reported among 22 infections, associated with ten non-polio types. Conclusion This study emphasizes the widespread circulation and severe nature of EV infections in Europe, particularly among neonates, as well as the (re-)emergence of specific types post-pandemic. Our findings highlight the need for continuous EV-surveillance to monitor variation in circulation, age, and clinical presentations, including paralysis among non-polio EV infections.
