Key result
Enterovirus D68 subclade A2/D predominates across Europe, with adults comprising ~63% of clinical cases.
Why the study?
Enterovirus D68 has predominantly infected children with subclade B3, but a substantial number of adult infections in 2025 prompted an investigation into the molecular epidemiology of the 2025 European season.
Observational (n=187)
Yes
In the 2025 European season, Enterovirus D68 demonstrated a continent-wide predominance of subclade A2/D and an epidemiological shift toward adult cases, alongside the emergence of interclade recombinant variants.
May prompt EV-D68 testing in adult respiratory illness; leaves open drivers of the apparent age shift.
Background Enterovirus D68 (EV-D68) has predominantly caused infections in children, and detected cases have mainly been infected by subclade B3. In 2025, however, a substantial number of infections in adults was noted. Aim To detail the molecular epidemiology of the 2025 season in Europe. Methods Case and sequencing data was collected from members in the European Non-Polio Enterovirus Network (ENPEN). The participating sites included both clinical and public health laboratories. Results Data was collected from 13 countries at 23 sites. There were 187 clinical cases infected with EV-D68 and 127 detections in wastewater. Age data were available for 76\% (143/187), among which 90 cases were adults. VP1-based genotyping showed subclade A2/D to predominate in all age groups and across all participating countries, as well as in the sewage sampling performed at one site. Two interclade recombinant sequences were detected among 22 whole genome sequences. Conclusion The observed shift towards adult cases and subclade A2/D predominance warrants continued monitoring to determine whether this represents a sustained epidemiological change. The detection of interclade recombinant variants highlights a need to supplement regular VP1-based genotyping with whole-genome sequencing.
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Dyrdak et al. (2026) conducted an observational in Enterovirus D68 (EV-D68) infection (n=187). Enterovirus D68 (EV-D68) subclade A2/D infection was evaluated on Molecular epidemiology and age distribution of EV-D68 cases. Enterovirus D68 subclade A2/D predominated across 13 European countries in 2025, with adults accounting for 90 of 143 (62.9%) clinical cases with available age data.
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