Enterovirus D68 Subclade B3 Strain Circulating and Causing an Outbreak in the United States in 2016

Abstract

In 2014 the United States experienced a nationwide outbreak of Enterovirus D68 (EV-D68) infection. There were no confirmed cases of EV-D68 in 2015 and CDC was only aware of limited sporadic EV-D68 detection in the US in 2016. In this report, we analyzed 749 nasopharyngeal (NP) specimens collected in 2015 and 2016 from patients in the Lower Hudson Valley, New York using a previously validated EV-D68-specific rRT-PCR assay. EV-D68 was detected in none of 199 NP specimens collected in 2015, and in one of 108 (0.9%) samples from January to May and 159 of 442 (36.0%) samples from July to October 2016. Complete EV-D68 genome sequences from 22 patients in 2016 were obtained using a metagenomic next-generation sequencing assay. Comparative genome analysis confirmed that a new EV-D68 strain belonging to subclade B3, with 3.2–4.8% divergence in nucleotide from subclade B1 strains identified during the 2014 US outbreak, was circulating in the US in 2016 and caused an outbreak in the Lower Hudson Valley, New York with 160 laboratory-confirmed cases. Our data highlight the genetic variability and capacity in causing outbreak by diverse EV-D68 strains, and the necessity of awareness and more surveillance on their active circulation worldwide.

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

“…Recently, the evolutionary analyses performed on complete genome sequences have suggested that subclade B3 was not originated by a mutation occurred on subclade B1 strains. Indeed, it has been suggested a distinct evolutionary origin for the new B3 subclade [45]. Multiple clades of EV-D68 have worldwide circulated simultaneously between 2005 and 2014 [9], while a predominance of one clade (subclade B3) has recently been observed.…”

Enteroviruses Remodel Autophagic Trafficking through Regulation of Host SNARE Proteins to Promote Virus Replication and Cell Exit

“…EV-D68 cases have been increasing in frequency and severity over the last decade, with outbreaks in the US in 2014 and 2016 (Midgley et al, 2015; Wang et al, 2017). It is likely that the number of cases is severely under-reported, as only the most severe clinical presentations are tested for EV-D68, allowing many infections to go undetected as asymptomatic or mild flu-like cases (Oberste et al, 2004).…”

Development and structural characterization of a two-MAb cocktail for delayed treatment of enterovirus D68 infections

“…In particular, from August 2014 to January 2015, a nationwide outbreak of EV-D68 infection occurred in the United States, resulting in 1,153 con rmed cases including 14 deaths 8,9 . EV-D68 outbreaks were also witnessed in the United States in 2016 and in 2018 10,11 , coinciding with the occurrence of 153 and 237 AFM cases, respectively 12 . In addition, an upsurge of EV-D68 infection was reported in several European countries in 2016 13,14,15 , accompanied by the identi cation of 29 EV-D68associated AFM cases 16 .…”