de Schrijver Sten, Vanhulle Emiel, Ingenbleek Anne, Alexakis Leonidas, Johannesen Caroline Klint, Broberg Eeva K, Harvala Heli, Fischer Thea K, Benschop Kimberley S M
Centre for Infectious Disease Control, Dutch National Public Health Institute, Bilthoven, The Netherlands.
European Program for Public Health Microbiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden.
J Infect Dis. 2025 Apr 4. doi: 10.1093/infdis/jiaf179.
Enteroviruses (EV) cause yearly outbreaks with severe infections, particularly in young children. This study investigates EV circulation, age-distribution, and clinical presentations in Europe from 2018-2023.
Aggregated data were requested from ECDC National Focal Points for Surveillance and European Non-Polio Enterovirus Network. Data included detection month, specimen type, age-group, and clinical presentation for the ten most commonly reported EV types per year.
Twenty-eight institutions from 16 countries reported 563,654 EV-tests during the study-period with 33,265 (5.9%) EV-positive. Forty-two types were identified (n=11,605 cases) with echovirus (E)30, coxsackievirus (CV)A6, EV-D68, E9, E11, CVB5, E18, CVB4, EV-A71, and E6 most frequently reported. E30 detection declined after 2018/2019, while CVA6, CVB5, E9, E11, and EV-D68 were prevalent both before and after the COVID-19 pandemic, and CVB4 and E18 were prevalent after the pandemic. Over the study period, a shift in seasons (summer to fall) and specimen positivity (feces to respiratory) was observed. Neurological signs predominated among EV-A71, CVB4, CVB5, E6, E9, E11, E18, and E30 (30-72%). CVB4, CVB5, E9, E11, and E18 were also frequently reported among neonates (18-32%). CVA6 was frequently associated with HFMD, and EV-D68 with respiratory infections. Paralysis was reported among 22 infections, associated with ten non-polio types.
This study emphasizes the widespread circulation and severe nature of EV infections in Europe, particularly among neonates, as well as the (re-)emergence of specific types post-pandemic. Our findings highlight the need for continuous EV-surveillance to monitor variation in circulation, age, and clinical presentations, including paralysis among non-polio EV infections.
肠道病毒（EV）每年都会引发严重感染的疫情，尤其是在幼儿中。本研究调查了2018年至2023年欧洲肠道病毒的传播情况、年龄分布和临床表现。
向欧洲疾病预防控制中心（ECDC）国家监测重点单位和欧洲非脊髓灰质炎肠道病毒网络索取汇总数据。数据包括每年报告的十种最常见肠道病毒类型的检测月份、标本类型、年龄组和临床表现。
来自16个国家的28个机构在研究期间报告了563,654次肠道病毒检测，其中33,265次（5.9%）呈肠道病毒阳性。共鉴定出42种类型（n = 11,605例），其中埃可病毒（E）30、柯萨奇病毒（CV）A6、肠道病毒D68、E9、E11、CVB5、E18、CVB4、肠道病毒A71和E6报告最为频繁。2018/2019年后E30的检测量下降，而CVA6、CVB5、E9、E11和肠道病毒D68在新冠疫情前后均很普遍，CVB4和E18在疫情后很普遍。在研究期间，观察到季节（从夏季到秋季）和标本阳性率（从粪便到呼吸道）的变化。在肠道病毒A71、CVB4、CVB5、E6、E9、E11、E18和E30感染中，神经系统症状占主导（30 - 72%）。CVB4、CVB5、E9、E11和E18在新生儿中也经常被报告（18 - 32%）。CVA6常与手足口病相关，肠道病毒D68常与呼吸道感染相关。在22例感染中报告了麻痹病例，与10种非脊髓灰质炎病毒类型有关。
本研究强调了肠道病毒感染在欧洲的广泛传播和严重性，特别是在新生儿中，以及疫情后特定类型的（再）出现。我们的研究结果凸显了持续进行肠道病毒监测的必要性，以监测传播、年龄和临床表现的变化，包括非脊髓灰质炎肠道病毒感染中的麻痹病例。
