The emergence of enterovirus D68 in a Dutch University Medical Center and the necessity for routinely screening for respiratory viruses

Poelman, Randy; Schölvinck, Elisabeth H.; Borger, Renze; Niesters, Hubert G. M.; Leer-Buter, Coretta van

doi:10.1016/j.jcv.2014.11.011

Cited by 89 publications

(94 citation statements)

References 8 publications

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“…Before this outbreak, EV-D68 was rarely reported and was associated with mild respiratory illness, although small outbreaks had been documented since 2005 (15,16,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Previous studies showed that the A, B, and C clades circulated or cocirculated during different time periods in different geographic regions (15,16,18,19,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)59). We further defined subclades A1, A2, B1, and B2.…”

Section: Discussionmentioning

confidence: 99%

Molecular Evolution and Intraclade Recombination of Enterovirus D68 during the 2014 Outbreak in the United States

Tan

Hassan

Schuster

et al. 2016

J Virol

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In August 2014, an outbreak of enterovirus D68 (EV-D68) occurred in North America, causing severe respiratory disease in children. Due to a lack of complete genome sequence data, there is only a limited understanding of the molecular evolution and epidemiology of EV-D68 during this outbreak, and it is uncertain whether the differing clinical manifestations of EV-D68 infection are associated with specific viral lineages. We developed a high-throughput complete genome sequencing pipeline for EV-D68 that produced a total of 59 complete genomes from respiratory samples with a 95% success rate, including 57 genomes from Kansas City, MO, collected during the 2014 outbreak. With these data in hand, we performed phylogenetic analyses of complete genome and VP1 capsid protein sequences. Notably, we observed considerable genetic diversity among EV-D68 isolates in Kansas City, manifest as phylogenetically distinct lineages, indicative of multiple introductions of this virus into the city. In addition, we identified an intersubclade recombination event within EV-D68, the first recombinant in this virus reported to date. Finally, we found no significant association between EV-D68 genetic variation, either lineages or individual mutations, and a variety of demographic and clinical variables, suggesting that host factors likely play a major role in determining disease severity. Overall, our study revealed the complex pattern of viral evolution within a single geographic locality during a single outbreak, which has implications for the design of effective intervention and prevention strategies. IMPORTANCEUntil recently, EV-D68 was considered to be an uncommon human pathogen, associated with mild respiratory illness. However, in 2014 EV-D68 was responsible for more than 1,000 disease cases in North America, including severe respiratory illness in children and acute flaccid myelitis, raising concerns about its potential impact on public health. Despite the emergence of EV-D68, a lack of full-length genome sequences means that little is known about the molecular evolution of this virus within a single geographic locality during a single outbreak. Here, we doubled the number of publicly available complete genome sequences of EV-D68 by performing high-throughput next-generation sequencing, characterized the evolutionary history of this outbreak in detail, identified a recombination event, and investigated whether there was any correlation between the demographic and clinical characteristics of the patients and the viral variant that infected them. Overall, these results will help inform the design of intervention strategies for EV-D68.

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Section: Discussionmentioning

confidence: 99%

Molecular Evolution and Intraclade Recombination of Enterovirus D68 during the 2014 Outbreak in the United States

Tan

Hassan

Schuster

et al. 2016

J Virol

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“…All samples that tested positive for EV and/or HRV RNA in the diagnostic test were screened with an EV-D68 specific real-time RT-PCR [9]. As part of the Danish enterovirus surveillance system all EV positive samples were further characterised at the National WHO Reference Laboratory for Poliovirus at SSI, using the routine genotyping assay which amplifies part of the VP2 or VP1 region [10,11] followed by Sanger sequencing [7].…”

Section: Laboratory Investigationmentioning

confidence: 99%

Emergence of enterovirus D68 in Denmark, June 2014 to February 2015

et al. 2015

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“…The same recommendation was made by the experts of the European Centre for Disease Prevention and Control (ECDC) [4]. After the publication of the ECDC document, there were reports that the incidence of respiratory infections due to EV-D68 had increased in The Netherlands [5] and Norway [6] during the late summer and early autumn of 2014, and that a number of these cases were associated with severe clinical manifestations [7].…”

Section: Introductionmentioning

confidence: 99%

Enterovirus D68-associated community-acquired pneumonia in children living in Milan, Italy

Esposito

Zampiero

Ruggiero

et al. 2015

Journal of Clinical Virology

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The emergence of enterovirus D68 in a Dutch University Medical Center and the necessity for routinely screening for respiratory viruses

Abstract: We observed an increase of EV-D68 infections in our population, both in children as well as in adult. In 2014 there have been 16 cases so far, compared to none in 2011 and 2013 and a single case in 2012. Phylogenetic analysis identified two similar clusters as shown in the USA and Canada.

Cited by 89 publications

References 8 publications

Molecular Evolution and Intraclade Recombination of Enterovirus D68 during the 2014 Outbreak in the United States

Molecular Evolution and Intraclade Recombination of Enterovirus D68 during the 2014 Outbreak in the United States

Emergence of enterovirus D68 in Denmark, June 2014 to February 2015

Enterovirus D68-associated community-acquired pneumonia in children living in Milan, Italy

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