title: VIRO-TypeNed, systematic molecular surveillance of enteroviruses in the Netherlands between 2010 and 2014.
abstract: VIRO-TypeNed is a collaborative molecular surveillance platform facilitated through a web-based database. Genetic data in combination with epidemiological, clinical and patient data are shared between clinical and public health laboratories, as part of the surveillance underpinning poliovirus eradication. We analysed the combination of data submitted from 2010 to 2014 to understand circulation patterns of non-polio enteroviruses (NPEV) of public health relevance. Two epidemiological patterns were observed based on VIRO-TypeNed data and classical surveillance data dating back to 1996: (i) endemic cyclic, characterised by predictable upsurges/outbreaks every two to four years, and (ii) epidemic, where rare virus types caused upsurges/outbreaks. Genetic analysis suggests continuous temporal displacement of virus lineages due to the accumulation of (silent) genetic changes. Non-synonymous changes in the antigenic B/C loop suggest antigenic diversification, which may affect population susceptibility. Infections were frequently detected at an age under three months and at an older, parenting age (25-49 years) pointing to a distinct role of immunity in the circulation patterns. Upsurges were detected in the summer and winter which can promote increased transmissibility underlying new (cyclic) upsurges and requires close monitoring. The combination of data provide a better understanding of NPEV circulation required to control and curtail upsurges and outbreaks.
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
authors.forename: Kimberley S M
authors.initials: KS
authors.lastname: Benschop
authors.forename: Janette C
authors.initials: JC
authors.lastname: Rahamat-Langendoen
authors.forename: Harrie G A M
authors.initials: HG
authors.lastname: van der Avoort
authors.forename: Eric C J
authors.initials: EC
authors.lastname: Claas
authors.forename: Suzan D
authors.initials: SD
authors.lastname: Pas
authors.forename: Rob
authors.initials: R
authors.lastname: Schuurman
authors.forename: Jaco J
authors.initials: JJ
authors.lastname: Verweij
authors.forename: Katja C
authors.initials: KC
authors.lastname: Wolthers
authors.forename: Hubert G M
authors.initials: HG
authors.lastname: Niesters
authors.forename: Marion P G
authors.initials: MP
authors.lastname: Koopmans
mesh_terms: D002984:Clinical Laboratory Information Systems; D030561:Databases, Nucleic Acid; D004196:Disease Outbreaks / Q000517:prevention & control; D019353:Endemic Diseases; D004770:Enterovirus / Q000235:genetics* / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D058872:Epidemics; D006801:Humans; D007753:Laboratories; D008969:Molecular Sequence Data; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D011634:Public Health; D012703:Serotyping
keywords: VIRO-TypeNed; circulation patterns; immunity; molecular surveillance; non-polio enterovirus; types