Key result
The combined global prevalence of current Enterovirus D68 infections was 4%, while the prevalence of past infections was 66.3%.
Why the study?
Although substantial epidemiological data emerged after the 2014 outbreak, the global case fatality rate and prevalence of current and past Enterovirus D68 infections needed to be mapped.
Meta-Analysis (n=204,351)
This meta-analysis highlights a low prevalence of current EV-D68 infections but high seroprevalence of past infections, with sporadic deaths linked to severe respiratory cases.
Answers are grounded in this paper and cite their sources.
Low current EV-D68 prevalence with sporadic fatalities warrants ongoing surveillance; leaves open prospective assessment of outbreak risk and interventions.
A substantial amount of epidemiological data has been reported on Enterovirus D68 (EV-D68) infections after the 2014 outbreak. Our goal was to map the case fatality rate (CFR) and prevalence of current and past EV-D68 infections. We conducted a systematic review (PROSPERO, CRD42021229255) with published articles on EV-68 infections in PubMed, Embase, Web of Science and Global Index Medicus up to January 2021. We determined prevalences using a model random effect. Of the 4,329 articles retrieved from the databases, 89 studies that met the inclusion criteria were from 39 different countries with apparently healthy individuals and patients with acute respiratory infections, acute flaccid myelitis and asthma-related diseases. The CFR estimate revealed occasional deaths (7/1353) related to EV-D68 infections in patients with severe acute respiratory infections. Analyses showed that the combined prevalence of current and past EV-D68 infections was 4% (95% CI = 3.1-5.0) and 66.3% (95% CI = 40.0-88.2), respectively. The highest prevalences were in hospital outbreaks, developed countries, children under 5, after 2014, and in patients with acute flaccid myelitis and asthma-related diseases. The present study shows sporadic deaths linked to severe respiratory EV-D68 infections. The study also highlights a low prevalence of current EV-D68 infections as opposed to the existence of EV-D68 antibodies in almost all participants of the included studies. These findings therefore highlight the need to implement and/or strengthen continuous surveillance of EV-D68 infections in hospitals and in the community for the anticipation of the response to future epidemics.
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Fall et al. (2022) conducted a meta-analysis in Enterovirus D68 infections (n=204,351). Enterovirus D68 infection was evaluated on Combined prevalence of current EV-D68 infections (95% CI 3.1-5.0). The combined global prevalence of current Enterovirus D68 infections was 4%, while the prevalence of past infections was 66.3%.
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