What does this research mean for the field?

EV-D68 exhibits a high seroprevalence (96.0%) across all pediatric age groups, with acute respiratory tract infection showing no significant association with seropositivity. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the neutralizing antibody profile, seroprevalence, and age-specific susceptibility of enterovirus D68 among children after the COVID-19 pandemic.

August 19, 2026VirusesOpen Access

Seroepidemiology of Enterovirus D68 in Xiamen Children: A Cross-Sectional Study in 2022

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Enterovirus D68 (EV-D68) exposure (n=453). Intervention: Acute respiratory tract infection (ARTI) vs. No acute respiratory tract infection. Primary outcome: EV-D68 seropositivity (neutralizing antibody titer ≥1:16) (OR 1.42, 95% CI 0.46-4.41, p=0.542).

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Key result

Acute respiratory tract infection is not associated with EV-D68 seropositivity in pediatric patients.

OR 1.42
95% CI 0.46-4.41
P=0.542
n=453

Why the study?

Seroprevalence data for Enterovirus D68 are essential for understanding population immunity, susceptibility, and transmission dynamics, but data after the COVID-19 pandemic are scarce.

Population

453 children aged 0-16 years in Xiamen, China

Comparison

217 children with ARTI vs 236 without ARTI

Design

Cross-sectional serological survey

Authors

LWLiting WangChildren's Hospital of Fudan University QZQiguo ZhuChildren’s Hospital of Fudan University Xiamen Branch YLYi LuChildren’s Hospital of Fudan University Xiamen Branch

Discussion

Member takes

Implication

High seroprevalence limits serology's diagnostic value for acute EV-D68 infection in children; extends post-pandemic seroepidemiology but leaves causal protection open.

Key Points

To evaluate the neutralizing antibody profile, seroprevalence, and age-specific susceptibility of enterovirus D68 among children after the COVID-19 pandemic.
Conducted a cross-sectional serological survey in 2022 enrolling 453 children aged 0–16 years (217 with acute respiratory tract infection [ARTI] and 236 without) in Xiamen, China.
Measured neutralizing antibody titers against the EV-D68 STL strain using a microneutralization assay, defining seropositivity as a titer ≥1:16.
Evaluated predictors of seropositivity and antibody levels using multivariable Firth's penalized logistic regression and analysis of covariance adjusting for age and sex.
Overall seroprevalence was 96.0% (435/453), remaining above 90.0% across all age categories (0–1 y: 100%; 1–3 y: 97.6%; 3–5 y: 92.6%; ≥5 y: 96.2%), with an overall geometric mean titer of 76.78 (95% CI: 68.32–85.24).
Acute respiratory tract infection status was not significantly associated with EV-D68 seropositivity after multivariable adjustment (adjusted OR = 1.42, 95% CI: 0.46–4.41, p = 0.542).
Antibody titers followed an age-dependent trajectory: infants <1 year had the highest geometric mean titer (86.31), whereas children aged 1–3 years showed the lowest geometric mean titer (63.52) and highest low-titer proportion.

Study Design

Type

Cross-Sectional (n=453)

Multicenter

Structured PICO

Population

453 children aged 0 to 16 years, including 217 with acute respiratory tract infection and 236 without, evaluated for EV-D68 neutralizing antibodies.

Outcome

EV-D68 neutralizing antibody seroprevalence (titer ≥1:16) and geometric mean titer (GMT)surrogate

Main Result

Odds Ratio: 1.42 (95% CI 0.46–4.41)

Absolute Event Rate: 96.8% vs 95.3%

p-value: p=0.542

EV-D68 circulates endemically among children in Xiamen, China, establishing a high population immune baseline (>90%) across all pediatric age groups.

Limitations

Absence of EV-D68-specific PCR testing precludes etiologic attribution of respiratory symptoms to EV-D68 infection.
Key covariates including daycare attendance, household size, and recent respiratory virus exposure history were not systematically documented.
Absence of EV-D68-specific PCR testing precludes etiologic attribution of respiratory symptoms to EV-D68 infection
Key covariates including daycare attendance, household size, and recent respiratory virus exposure history were not systematically documented

Cite This Study

Wang et al. (2026) conducted a cross-sectional in Enterovirus D68 (EV-D68) exposure (n=453). Acute respiratory tract infection (ARTI) vs. No acute respiratory tract infection was evaluated on EV-D68 seropositivity (neutralizing antibody titer ≥1:16) (OR 1.42, 95% CI 0.46-4.41, p=0.542). Acute respiratory tract infection was not significantly associated with EV-D68 seropositivity (adjusted OR 1.42) in a pediatric population with an overall high seroprevalence of 96.0%.

synapsesocial.com/papers/6a8563d703308d306e2d7488 https://doi.org/10.3390/v18080903

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Implication

High seroprevalence limits serology's diagnostic value for acute EV-D68 infection in children; extends post-pandemic seroepidemiology but leaves causal protection open.

Seroepidemiology of Enterovirus D68 in Xiamen Children: A Cross-Sectional Study in 2022

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Seroepidemiology of Enterovirus D68 in Xiamen Children: A Cross-Sectional Study in 2022

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider