20.500.12556/DiRROS-22797 Sustained circulation of enterovirus D68 in Europe in 2023 and the continued evolution of enterovirus D68 B3-lineages associated with distinct amino acid substitutions in VP1 protein Background Enterovirus D68 (EV-D68) causes respiratory disease ranging from mild to severe and in rare cases a paralytic syndrome, called acute flaccid myelitis (AFM). Since the global EV-D68 outbreak in 2014, the virus has mainly circulated in biennial epidemic cycles with peaks detected during even years. However, following the COVID-19 pandemic, the seasonal pattern of EV-D68 has been characterized by large yearly upsurges. Here, we describe the circulation of EV-D68 in Europe in 2023 and track its genetic evolution. Study design Data was compiled from members of the European Non-Polio Network (ENPEN). This included monthly data on the total number of EV samples tested, EV positive samples, EV-D68 positive samples and cases, and other EV positive samples detected in 2023. Information on sample types and surveillance system was recorded. Sequence data from the VP1 gene was used for phylogenetic and amino acid sequence analysis. Results EV was detected in 13,585 out of 203,622 diagnostic samples tested (6.7 %), of which 402 (3.0 %) were determined as EV-D68, representing 386 cases. EV-D68 infections peaked in October 2023 (136/386; 35.2 %). 267/386 (69.2 %) of EV-D68 cases were captured through clinical EV surveillance, almost all of which (202/204 of positive samples with sample type information) were detected in respiratory specimens. Phylogenetic analysis performed on 99 VP1 sequences revealed a distinct B3-derived lineage with a previously undescribed residue change, D554E, in Europe. Conclusions The study documents sustained circulation of EV-D68 in Europe in 2023, the evolution of B3-derived lineages, and appearance of previously undescribed amino acid substitutions in Europe. This stresses the need for continuous EV-D68 surveillance and harmonization of EV-D68 detection practices towards better data comparability across countries. Enterovirus D68 (EV-D68) Europe Epidemiology B3-derived lineages Surveillance true false true Elsevier B.V. Angleški jezik Ni določen Neznano 2025-06-27 08:02:16 2025-06-27 08:02:16 2025-10-24 03:52:12 0000-00-00 00:00:00 2025 0 0 Soavtorji: Caroline Klint Johannesen, Peter Simmonds, Thea K. Fischer, Heli Harvala, Kimberley S.M. Benschop, on behalf of ENPEN study collaborators; Slovenski člani raziskovalne skupine: Nataša Beginc, Maja M. Lunar, Mario Poljak, Miroslav Petrovec, Tina Uršič; Nasl. z nasl. zaslona; Opis vira z dne 4. 6. 2025; Str. 1-10 [št. članka] 105785 Letn. 178 Jun. 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 2024-11-14 2025-03-29 2025-04-05 616.9 1873-5967 10.1016/j.jcv.2025.105785 238239235 Hirvonen_et_al_2025_Sustained_circulation.pdf Hirvonen_et_al_2025_Sustained_circulation.pdf 1 ACBE1CF473CE6CFA580FA3D90196159B 994af27503fdda6de4afbb2e1ad6188dd434067147fd5df2f533f818886c79c3 3e4d1470-531d-11f0-8080-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=33130 https://www.sciencedirect.com/science/article/pii/S1386653225000277?via%3Dihub 1 486e65ab-531c-11f0-8080-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=33129 https://doi.org/10.1016/j.jcv.2025.105785 0 46862e47-531d-11f0-8080-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=33131 Nacionalni laboratorij za zdravje, okolje in hrano 0 0 0