Re-emergence of enterovirus D68 in Europe after easing the COVID-19 lockdown, September 2021

Author:

Benschop Kimberley SM1,Albert Jan23,Anton Andres4,Andrés Cristina4,Aranzamendi Maitane5,Armannsdóttir Brynja6,Bailly Jean-Luc78,Baldanti Fausto910,Baldvinsdóttir Guðrún Erna6,Beard Stuart11,Berginc Natasa12,Böttcher Sindy13,Blomqvist Soile14,Bubba Laura15,Calvo Cristina16,Cabrerizo Maria17,Cavallero Annalisa18,Celma Cristina11,Ceriotti Ferruccio19,Costa Inês20,Cottrell Simon21,del Cuerpo Margarita22,Dean Jonathan23,Dembinski Jennifer L24,Diedrich Sabine13,Diez-Domingo Javier25,Dorenberg DagnyHaug24,Duizer Erwin1,Dyrdak Robert23,Fanti Diana26,Farkas Agnes27,Feeney Susan28,Flipse Jacky29,De Gascun Cillian23,Galli Cristina15,Georgieva Irina30,Gifford Laura21,Guiomar Raquel20,Hönemann Mario31,Ikonen Niina14,Jeannoël Marion32,Josset Laurence32,Keeren Kathrin33,López-Labrador F Xavier3425,Maier Melanie31,McKenna James28,Meijer Adam1,Mengual-Chuliá Beatriz25,Midgley Sofie E35,Mirand Audrey78,Montes Milagrosa5,Moore Catherine21,Morley Ursula23,Murk Jean-Luc36,Nikolaeva-Glomb Lubomira30,Numanovic Sanela24,Oggioni Massimo19,Palminha Paula20,Pariani Elena15,Pellegrinelli Laura15,Piralla Antonio10,Pietsch Corinna31,Piñeiro Luis5,Rabella Núria22,Rainetova Petra37,Uceda Renteria Sara Colonia19,Romero María P15,Reynders Marijke37,Roorda Lieuwe38,Savolainen-Kopra Carita14,Schuffenecker Isabelle32,Soynova Aysa30,Swanink Caroline MA29,Ursic Tina39,Verweij Jaco J36,Vila Jorgina40,Vuorinen Tytti41,Simmonds Peter42,Fischer Thea K4344,Harvala Heli4546

Affiliation:

1. Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands

2. Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

3. Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden

4. Respiratory Virus Unit, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain

5. Microbiology Department, Donostia University Hospital and Biodonostia Health Research Institute, San Sebastián, Spain

6. Landspitali-National University Hospital, Reykjavik, Iceland

7. Université d’Auvergne, LMGE UMR CNRS 6023, Equipe EPIE - Epidémiologie et physiopathologie des infections à entérovirus, Faculté de Médecine, Clermont-Ferrand, France

8. CHU Clermont-Ferrand, National Reference Centre for enteroviruses and parechoviruses – Associated laboratory, Clermont-Ferrand, France

9. Department of Clinical Surgical Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy

10. Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy

11. UK Health Security Agency, Colindale, United Kingdom

12. National laboratory of health, environment and food, Laboratory for public health virology, Ljubljana, Slovenia

13. National Reference Center for Poliomyelitis and Enteroviruses, Robert-Koch Institute, Berlin, Germany

14. National Institute for Health and Welfare, Helsinki, Finland

15. Department of Biomedical Sciences of Health, University of Milan, Milan, Italy

16. Hospital Universitario La Paz, Madrid, Spain

17. National Centre for Microbiology, Instituto de Salud Carlos III, Enterovirus and Viral Gastroenteritis Unit/Polio National Lab, Madrid, Spain

18. Laboratory of Microbiology, ASST Monza, San Gerardo Hospital, Monza (MB), Italy

19. Virology Unit, Division of Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy

20. National Institute of Health (INSA), Lisbon, Portugal

21. Public Health Wales, Cardiff, United Kingdom

22. Microbiology Department Hospital Universitari de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

23. National Virus Reference Laboratory, University College Dublin, Dublin, Ireland

24. Department of Virology, Norwegian Institute of Public Health, Oslo, Norway

25. Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Valencia, Spain

26. Chemical-clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

27. National Public Health Center, Budapest, Hungary

28. Regional Virus Laboratory, Belfast Health and Social Care Trust (BHSCT, Royal Victoria Hospital, Belfast, United Kingdom

29. Laboratory for Medical Microbiology and Immunology, Rijnstate, Velp, the Netherlands

30. National Reference Laboratory for Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria

31. Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany

32. National Reference Center for Enteroviruses and Parechoviruses, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France

33. Secretary of the commission for Polio Eradication in Germany, Robert-Koch Institute, Berlin, Germany

34. CIBERESP, Instituto de Salud Carlos III, Madrid, Spain

35. The Danish WHO National Reference Laboratory for Poliovirus, Statens Serum Institut, Copenhagen, Denmark

36. Elisabeth Tweesteden Hospital, Tilburg, the Netherlands

37. National Institute of Public Health, Prague, Czech Republic

38. Maasstad Hospital, Rotterdam, the Netherlands

39. Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

40. Pediatric Hospitalization Unit, Department of Pediatrics, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain

41. Clinical Microbiology, Turku University Hospital and Institute of Biomedicine, University of Turku, Turku, Finland

42. University of Oxford, Oxford, United Kingdom

43. Nordsjaellands Hospital, Hillerod, Denmark

44. University of Sothern Denmark, Odense, Denmark

45. University College London (UCL), Department of infection and Immunity, London, United Kingdom

46. NHS Blood and Transplant, Microbiology Services, Colindale, United Kingdom

Abstract

We report a rapid increase in enterovirus D68 (EV-D68) infections, with 139 cases reported from eight European countries between 31 July and 14 October 2021. This upsurge is in line with the seasonality of EV-D68 and was presumably stimulated by the widespread reopening after COVID-19 lockdown. Most cases were identified in September, but more are to be expected in the coming months. Reinforcement of clinical awareness, diagnostic capacities and surveillance of EV-D68 is urgently needed in Europe.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

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