title: Emergence and epidemic occurrence of enterovirus 68 respiratory infections in The Netherlands in 2010.
abstract: Following an increase in detection of enterovirus 68 (EV68) in community surveillance of respiratory infections in The Netherlands in 2010, epidemiological and virological analyses were performed to investigate the possible public health impact of EV68 infections. We retrospectively tested specimens collected from acute respiratory infections surveillance and through three children cohort studies conducted in The Netherlands from 1994 through 2010. A total of 71 of 13,310 (0.5%) specimens were positive for EV68, of which 67 (94%) were from symptomatic persons. Twenty-four (34%) of the EV68 positive specimens were collected during 2010. EV68-positive patients with respiratory symptoms showed significantly more dyspnea, cough and bronchitis than EV68-negative patients with respiratory symptoms. Phylogenetic analysis showed an increased VP1 gene diversity in 2010, suggesting that the increased number of EV68 detections in 2010 reflects a real epidemic. Clinical laboratories should consider enterovirus diagnostics in the differential diagnosis of patients presenting with respiratory symptoms.
authors.affiliation: Center for Infectious Disease Control, Laboratory for Infectious Diseases and Perinatal Screening, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. adam.meijer@rivm.nl
authors.forename: Adam
authors.initials: A
authors.lastname: Meijer
authors.forename: Sabine
authors.initials: S
authors.lastname: van der Sanden
authors.forename: Bianca E P
authors.initials: BE
authors.lastname: Snijders
authors.forename: Giovanna
authors.initials: G
authors.lastname: Jaramillo-Gutierrez
authors.forename: Louis
authors.initials: L
authors.lastname: Bont
authors.forename: Cornelis K
authors.initials: CK
authors.lastname: van der Ent
authors.forename: Pieter
authors.initials: P
authors.lastname: Overduin
authors.forename: Shireen L
authors.initials: SL
authors.lastname: Jenny
authors.forename: Edin
authors.initials: E
authors.lastname: Jusic
authors.forename: Harrie G A M
authors.initials: HG
authors.lastname: van der Avoort
authors.forename: Gavin J D
authors.initials: GJ
authors.lastname: Smith
authors.forename: Gé A
authors.initials: GA
authors.lastname: Donker
authors.forename: Marion P G
authors.initials: MP
authors.lastname: Koopmans
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D030016:Enterovirus D, Human / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000821:virology; D058872:Epidemics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009426:Netherlands / Q000453:epidemiology; D010802:Phylogeny; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D012189:Retrospective Studies; D055815:Young Adult