title: The emergence of enterovirus D68 in England in autumn 2014 and the necessity for reinforcing enterovirus respiratory screening.
abstract: In autumn 2014, enterovirus D68 (EV-D68) cases presenting with severe respiratory or neurological disease were described in countries worldwide. To describe the epidemiology and virological characteristics of EV-D68 in England, we collected clinical information on laboratory-confirmed EV-D68 cases detected in secondary care (hospitals), between September 2014 and January 2015. In primary care (general practitioners), respiratory swabs collected (September 2013-January 2015) from patients presenting with influenza-like illness were tested for EV-D68. In secondary care 55 EV-D68 cases were detected. Among those, 45 cases had clinical information available and 89% (40/45) presented with severe respiratory symptoms. Detection of EV-D68 among patients in primary care increased from 0.4% (4/1074; 95% CI 0.1-1.0) (September 2013-January 2014) to 0.8% (11/1359; 95% CI 0.4-1.5) (September 2014-January 2015). Characterization of EV-D68 strains circulating in England since 2012 and up to winter 2014/2015 indicated that those strains were genetically similar to those detected in 2014 in USA. We recommend reinforcing enterovirus surveillance through screening respiratory samples of suspected cases.
authors.affiliation: European Program for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC),Stockholm,Sweden.
authors.forename: A I
authors.identifier: 0000-0002-8845-3447
authors.initials: AI
authors.lastname: Carrion Martin
authors.affiliation: Public Health England (PHE),London,UK.
authors.forename: R G
authors.initials: RG
authors.lastname: Pebody
authors.affiliation: European Program for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC),Stockholm,Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Danis
authors.affiliation: Public Health England (PHE),London,UK.
authors.forename: J
authors.initials: J
authors.lastname: Ellis
authors.affiliation: Public Health England (PHE),London,UK.
authors.forename: S
authors.initials: S
authors.lastname: Niazi
authors.affiliation: Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC),Euston,London,UK.
authors.forename: S
authors.initials: S
authors.lastname: DE Lusignan
authors.affiliation: Public Health England (PHE),London,UK.
authors.forename: K E
authors.initials: KE
authors.lastname: Brown
authors.affiliation: Public Health England (PHE),London,UK.
authors.forename: M
authors.initials: M
authors.lastname: Zambon
authors.affiliation: Public Health England (PHE),London,UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Allen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D030016:Enterovirus D, Human / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010802:Phylogeny; D015995:Prevalence; D011320:Primary Health Care; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D012621:Seasons; D063127:Secondary Health Care; D014760:Viral Fusion Proteins / Q000235:genetics; D055815:Young Adult
chemical_list: D014760:Viral Fusion Proteins
keywords: Enterovirus D68; neurologic manifestations; respiratory infections; respiratory samples