ETIDIOH - NEW

Abstract Enterovirus D68 (EV-D68) caused large biennial cyclical outbreaks of respiratory disease and cases of acute flaccid myelitis from 2014 to 2018 in the USA . An anticipated outbreak did not occur in 2020, likely due to non-pharmaceutical interventions targeting the COVID-19 pandemic. A large respiratory disease outbreak occurred again in 2022 , but uncertainty remained regarding if circulation of EV-D68 would return to the pre-pandemic patterns. We conducted prospective active surveillance of clinical respiratory specimens from Colorado children for EV-D68 in 2023 and 2024. A subset of residual specimens positive for rhinovirus/enterovirus (RV/EV) were tested for EV-D68 via a validated in-house EV-D68 reverse transcription–PCR assay. During epi weeks 18–44 in 2023, 525 residual specimens positive for RV/EV all tested negative for EV-D68. In 2024, during epi weeks 18–44 , 10 ( 1.8% ) of the 546 RV/EV-positive specimens were EV-D68-positive . The EV-D68-positive cases were predomi...

Highlights •  Enterovirus D68 (EV-D68) was circulating in Europe in 2023 •  Most EV-D68 cases were captured through clinical EV surveillance •  Phylogenetic analysis of the VP1 region revealed a distinct B3-derived lineage •  The identified B3 lineage presented a previously undescribed residue change, D554E Abstract Background Enterovirus D68 (EV-D68) causes respiratory disease ranging from mild to severe and in rare cases a paralytic syndrome, called acute flaccid myelitis (AFM). Since the global EV-D68 outbreak in 2014, the virus has mainly circulated in biennial epidemic cycles with peaks detected during even years. However, following the COVID-19 pandemic, the seasonal pattern of EV-D68 has been characterized by large yearly upsurges . Here, we describe the circulation of EV-D68 in Europe in 2023 and track its genetic evolution. Study design Data was compiled from members of the European Non-Polio Network (ENPEN). This included monthly data on the total number of...