Key result
Enterovirus D68 accounts for ~6% of enterovirus cases, resurging with clade A2/D dominance post-pandemic.
Why the study?
Enterovirus D68 represents a continuing public health concern given its association with severe respiratory illness and neurologic complications.
Observational (n=61,297)
Yes
EV-D68 exhibits persistent adaptation, shifting subgenogroup predominance, and post-pandemic resurgence in Europe, necessitating continuous genomic surveillance to monitor transmission and antigenic changes.
May prompt renewed clinical vigilance for EV-D68; extends European surveillance data but leaves open A2/D clade risks.
Enterovirus D68 (EV-D68) represents a continuing public health concern, given its association with severe respiratory illness and neurologic complications. In this study, we analyzed EV-D68 circulation and genetic evolution during 2014-2024 using data from 18 countries in Europe. Of 61,297 enterovirus-positive specimens, molecular detection and viral protein 1 sequencing identified 3,541 (6%) EV-D68 cases. A biennial circulation pattern was observed; detection rates ranged from 9% in 2014 to 0.9% in 2019. The pattern was disrupted in 2020 because of measures implemented in response to the COVID-19 pandemic, but then notable increases occurred in 2021 (14%), 2022 (10.7%), and 2024 (20.6%). Subgenogroups B3 (59.8%) and A2/D (28.0%) were predominant; A2/D reemerged as dominant in 2024. Mutation analyses revealed changes in antigenic regions. Our findings underscore the persistent adaptation and resurgence of EV-D68 after COVID-19. Continued genomic surveillance is essential to monitor transmission patterns caused by antigenic changes.
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Andrés et al. (2026) conducted an observational in Enterovirus D68 (EV-D68) infection (n=61,297). Enterovirus D68 vs. Other enteroviruses was evaluated on Prevalence of EV-D68 cases among enterovirus-positive specimens. Enterovirus D68 accounted for 6% of enterovirus-positive cases and exhibited a biennial circulation pattern that was disrupted by the COVID-19 pandemic, followed by a resurgence dominated by the A2/D clade (82.1%) in 2024.
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