Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milano, Italy.
J Clin Virol. 2018 Feb-Mar;99-100:91-96. doi: 10.1016/j.jcv.2018.01.005. Epub 2018 Jan 12.
In recent years, several outbreaks due to Enterovirus D-68 (EV-D68) have been reported, and it was confirmed that the virus can cause upper and lower respiratory tract diseases and be associated with the development of neurological problems.
The main aim of this research was to study the genetic characteristics of EV-D68 strains that were circulating in Italy identified during an outbreak of an EV-D68 infection that occurred in Italy during the period March-October 2016.
A retrospective study of the circulation of different types and subtypes of EV-D68 was performed. Nasopharyngeal swabs were collected from March 2016 through October 2016 in children admitted to the Emergency Room with respiratory diseases.
Among 390 children, 22 (59.1% males; mean age 47 months) were found to be infected by EV-D68 and most of them were immunocompetent (72.7%). Pneumonia was diagnosed in 12 (54.5%) children. Phylogenetic analysis of the VP1 region showed that all the strains identified in this study belonged to clade B3. Within B3 subclade, the Italian EV-D68 strains were most closely related to strains detected in Southern China in 2015 as well as to strains detected in US and the Netherlands in 2016.
These results showed that EV-D68 infections are a common cause of lower respiratory illness in pediatric age. The circulation of one EV-D68 lineage has been proven in Italy and in the European region during 2016. However, further studies are required to investigate whether some strains or lineages may possess a higher affinity for the lower airway or central nervous system.
近年来，已报告多起因肠道病毒 D-68（EV-D68）引起的暴发疫情，且证实该病毒可引起上下呼吸道疾病，并与神经问题的发生有关。
本研究的主要目的是研究 2016 年 3 月至 10 月期间在意大利暴发的 EV-D68 感染中循环的 EV-D68 株的遗传特征。
对不同类型和亚型的 EV-D68 进行了回顾性研究。从 2016 年 3 月至 2016 年 10 月，对因呼吸道疾病入住急诊室的儿童采集鼻咽拭子。
在 390 名儿童中，有 22 名（59.1%为男性；平均年龄为 47 个月）被 EV-D68 感染，其中大多数为免疫功能正常者（72.7%）。12 名（54.5%）儿童被诊断为肺炎。VP1 区的系统进化分析表明，本研究中鉴定的所有毒株均属于 B3 分支。在 B3 亚分支内，意大利 EV-D68 株与 2015 年在中国南方以及 2016 年在美国和荷兰检测到的毒株最为密切相关。
这些结果表明，EV-D68 感染是儿科下呼吸道疾病的常见病因。2016 年，意大利和欧洲地区已证实存在一种 EV-D68 株系的循环。然而，还需要进一步的研究来调查某些毒株或株系是否可能对下呼吸道或中枢神经系统具有更高的亲和力。
