EV-D68 can co-circulate and cause severe neurological manifestations even during seasons of expected low prevalence, highlighting the need for continuous surveillance.
Supports year-round EV-D68 surveillance amid neurologic cases; leaves open drivers of subclade emergence and severity.
Enterovirus D68 (EV-D68) was detected in 93 patients from five European countries between 1 January 2019 and 15 January 2020, a season with expected low circulation. Patients were primarily children (n = 67, median age: 4 years), 59 patients required hospitalisation and five had severe neurologic manifestations. Phylogenetic analysis revealed two clusters in the B3 subclade and subclade A2/D. This circulation of EV-D68 associated with neurological manifestations stresses the importance of surveillance and diagnostics beyond expected peak years.
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Midgley et al. (2020) studied this question.
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