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1.
Euro Surveill ; 26(45)2021 Nov.
Article in English | MEDLINE | ID: covidwho-1630353

ABSTRACT

We report a rapid increase in enterovirus D68 (EV-D68) infections, with 139 cases reported from eight European countries between 31 July and 14 October 2021. This upsurge is in line with the seasonality of EV-D68 and was presumably stimulated by the widespread reopening after COVID-19 lockdown. Most cases were identified in September, but more are to be expected in the coming months. Reinforcement of clinical awareness, diagnostic capacities and surveillance of EV-D68 is urgently needed in Europe.


Subject(s)
COVID-19 , Enterovirus D, Human , Enterovirus Infections , Enterovirus , Myelitis , Respiratory Tract Infections , Communicable Disease Control , Disease Outbreaks , Enterovirus D, Human/genetics , Enterovirus Infections/diagnosis , Enterovirus Infections/epidemiology , Europe/epidemiology , Humans , Myelitis/epidemiology , SARS-CoV-2
2.
MMWR Morb Mortal Wkly Rep ; 70(47): 1623-1628, 2021 Nov 26.
Article in English | MEDLINE | ID: covidwho-1534933

ABSTRACT

Enterovirus D68 (EV-D68) is associated with a broad spectrum of illnesses, including mild to severe acute respiratory illness (ARI) and acute flaccid myelitis (AFM). Enteroviruses, including EV-D68, are typically detected in the United States during late summer through fall, with year-to-year fluctuations. Before 2014, EV-D68 was infrequently reported to CDC (1). However, numbers of EV-D68 detection have increased in recent years, with a biennial pattern observed during 2014-2018 in the United States, after the expansion of surveillance and wider availability of molecular testing. In 2014, a national outbreak of EV-D68 was detected (2). EV-D68 was also reported in 2016 via local (3) and passive national (4) surveillance. EV-D68 detections were limited in 2017, but substantial circulation was observed in 2018 (5). To assess recent levels of circulation, EV-D68 detections in respiratory specimens collected from patients aged <18 years* with ARI evaluated in emergency departments (EDs) or admitted to one of seven U.S. medical centers† within the New Vaccine Surveillance Network (NVSN) were summarized. This report provides a provisional description of EV-D68 detections during July-November in 2018, 2019 and 2020, and describes the demographic and clinical characteristics of these patients. In 2018, a total of 382 EV-D68 detections in respiratory specimens obtained from patients aged <18 years with ARI were reported by NVSN; the number decreased to six detections in 2019 and 30 in 2020. Among patients aged <18 years with EV-D68 in 2020, 22 (73%) were non-Hispanic Black (Black) persons. EV-D68 detections in 2020 were lower than anticipated based on the biennial circulation pattern observed since 2014. The circulation of EV-D68 in 2020 might have been limited by widespread COVID-19 mitigation measures; how these changes in behavior might influence the timing and levels of circulation in future years is unknown. Ongoing monitoring of EV-D68 detections is warranted for preparedness for EV-D68-associated ARI and AFM.


Subject(s)
Disease Outbreaks , Enterovirus D, Human/isolation & purification , Enterovirus Infections/epidemiology , Population Surveillance/methods , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Adolescent , Child , Child, Preschool , Enterovirus D, Human/genetics , Enterovirus Infections/virology , Female , Humans , Infant , Male , United States/epidemiology
3.
Euro Surveill ; 26(43)2021 10.
Article in English | MEDLINE | ID: covidwho-1533602

ABSTRACT

We report a large-scale outbreak of hand, foot and mouth disease (HFMD) in France. As at 28 September 2021, 3,403 cases have been reported (47% higher than in 2018-19). We prospectively analysed 210 clinical samples; 190 (90.5%) were enterovirus-positive. Most children presented with atypical HFMD. Coxsackievirus (CV)A6 (49.5%; 94/190) was predominant; no enterovirus A71 was detected. Dermatological and neurological complications of HFMD justify prospective syndromic and virological surveillance for early detection of HFMD outbreaks and identification of associated types.


Subject(s)
Enterovirus Infections , Enterovirus , Hand, Foot and Mouth Disease , Child , Disease Outbreaks , Enterovirus Infections/epidemiology , Hand, Foot and Mouth Disease/diagnosis , Hand, Foot and Mouth Disease/epidemiology , Humans , Infant , Prospective Studies
4.
Clin Infect Dis ; 73(9): e2807-e2809, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1501044

ABSTRACT

Enteroviral meningitis is seasonal, typically exhibiting a rise in prevalence in late summer/early fall. Based on clinical microbiology laboratory testing data of cerebrospinal fluid, the expected August/September/October peak in enteroviral meningitis did not occur in 2020, possibly related to coronavirus disease 2019 (COVID-19) mitigation strategies.


Subject(s)
COVID-19 , Enterovirus Infections , Enterovirus , Meningitis, Viral , Enterovirus Infections/epidemiology , Enterovirus Infections/prevention & control , Humans , Infant , Meningitis, Viral/diagnosis , Meningitis, Viral/epidemiology , Meningitis, Viral/prevention & control , SARS-CoV-2
5.
Viruses ; 13(9)2021 09 10.
Article in English | MEDLINE | ID: covidwho-1411079

ABSTRACT

We used wastewater-based epidemiology and amplicon-based long-read high-throughput sequencing for surveillance of enteroviruses (EVs) in Maricopa County, Arizona, Southwest United States. We collected 48 samples from 13 sites in three municipalities between 18 June and 1 October 2020, and filtered (175 mL each; 0.45 µm pore size) and extracted RNA from the filter-trapped solids. The RNA was converted to cDNA and processed through two workflows (Sanger sequencing (SSW) and long-read Illumina sequencing (LRISW)) each including a nested polymerase chain reaction (nPCR) assay. We subjected the ~350 bp amplicon from SSW to Sanger sequencing and the ~1900-2400 bp amplicon from LRISW to Illumina sequencing. We identified EV contigs from 11 of the 13 sites and 41.67% (20/48) of screened samples. Using the LRISW, we detected nine EV genotypes from three species (Enterovirus A (CVA4, EV-A76, EV-A90), Enterovirus B (E14) and Enterovirus C (CVA1, CVA11, CVA13, CVA19 and CVA24)) with Enterovirus C representing approximately 90% of the variants. However, the SSW only detected the five Enterovirus C types. Similarity and phylogenetic analysis showed that multiple Enterovirus C lineages were circulating, co-infecting and recombining in the population during the season despite the SARS-CoV-2 pandemic and the non-pharmaceutical public health measures taken to curb transmission.


Subject(s)
Enterovirus Infections/epidemiology , Enterovirus Infections/virology , Enterovirus/genetics , Waste Water/microbiology , Water Microbiology , Arizona/epidemiology , Enterovirus/isolation & purification , Enterovirus Infections/history , High-Throughput Nucleotide Sequencing , History, 21st Century , Humans , Phylogeny , RNA, Viral , Seasons , Wastewater-Based Epidemiological Monitoring
6.
Viruses ; 13(1)2021 Jan 07.
Article in English | MEDLINE | ID: covidwho-1389524

ABSTRACT

We describe the complete capsid of a genotype C1-like Enterovirus A71 variant recovered from wastewater in a neighborhood in the greater Tempe, Arizona area (Southwest United States) in May 2020 using a pan-enterovirus amplicon-based high-throughput sequencing strategy. The variant seems to have been circulating for over two years, but its sequence has not been documented in that period. As the SARS-CoV-2 pandemic has resulted in changes in health-seeking behavior and overwhelmed pathogen diagnostics, our findings highlight the importance of wastewater-based epidemiology (WBE ) as an early warning system for virus surveillance.


Subject(s)
Capsid Proteins/genetics , Enterovirus A, Human/genetics , Enterovirus A, Human/isolation & purification , High-Throughput Nucleotide Sequencing/methods , Waste Water/virology , Wastewater-Based Epidemiological Monitoring , Arizona/epidemiology , Capsid/chemistry , Enterovirus Infections/epidemiology , Enterovirus Infections/virology , Humans , Molecular Epidemiology , Pandemics , Phylogeny
7.
J Med Virol ; 93(7): 4392-4398, 2021 07.
Article in English | MEDLINE | ID: covidwho-1263103

ABSTRACT

With the arrival of coronavirus disease 2019 (COVID-19) in Brazil in February 2020, several preventive measures were taken by the population aiming to avoid severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection including the use of masks, social distancing, and frequent hand washing then, these measures may have contributed to preventing infection also by other respiratory viruses. Our goal was to determine the frequencies of Influenza A and B viruses (FLUAV/FLUBV), human mastadenovirus C (HAdV-C), Enterovirus 68 (EV-68), and rhinovirus (RV) besides SARS-CoV-2 among hospitalized patients suspect of COVID-19 with cases of acute respiratory disease syndrome (ARDS) in the period of March to December 2020 and to detect possible coinfections among them. Nucleic acid detection was performed using reverse-transcription quantitative polymerase chain reaction (RT-qPCR) in respiratory samples using naso-oropharyngeal swabs and bronchoalveolar lavage. A total of 418 samples of the 987 analyzed (42.3%) were positive for SARS-CoV-2, 16 (1.62%) samples were positive for FLUAV, no sample was positive for FLUBV or EV-68, 67 (6.78%) samples were positive for HAdV-C, 55 samples were positive for RV 1/2 (26.3%) and 37 for RV 2/2 (13.6%). Coinfections were also detected, including a triple coinfection with SARS-CoV-2, FLUAV, and HAdV-C. In the present work, a very low frequency of FLUV was reported among hospitalized patients with ARDS compared to the past years, probably due to preventive measures taken to avoid COVID-19 and the high influenza vaccination coverage in the region in which this study was performed.


Subject(s)
Adenoviridae Infections/epidemiology , COVID-19/epidemiology , Common Cold/epidemiology , Enterovirus Infections/epidemiology , Influenza, Human/epidemiology , Physical Distancing , Adenoviridae Infections/prevention & control , Adolescent , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , COVID-19/prevention & control , Child , Child, Preschool , Coinfection/epidemiology , Coinfection/virology , Common Cold/prevention & control , Enterovirus D, Human/genetics , Enterovirus D, Human/isolation & purification , Enterovirus Infections/prevention & control , Female , Humans , Infant , Influenza A virus/genetics , Influenza A virus/isolation & purification , Influenza B virus/genetics , Influenza B virus/isolation & purification , Influenza, Human/prevention & control , Male , Masks , Mastadenovirus/genetics , Mastadenovirus/isolation & purification , Middle Aged , Nucleic Acid Amplification Techniques/methods , Reverse Transcriptase Polymerase Chain Reaction/methods , Rhinovirus/genetics , Rhinovirus/isolation & purification , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Young Adult
8.
Commun Dis Intell (2018) ; 452021 Jan 29.
Article in English | MEDLINE | ID: covidwho-1080878

ABSTRACT

ABSTRACT: Significant reductions in the incidence of enteroviruses and noroviruses, both transmitted primarily by the faecal-oral route, were noted in 2020 compared to the previous decade, in Victoria, Australia. The enterovirus specimen positivity rate was reduced by 84.2% in 2020, while the norovirus outbreak positivity rate declined by 49.0%. The most likely explanation for these reductions is the concurrence of social restrictions, physical distancing, personal hygiene awareness and international and domestic border closures in response to the COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , Caliciviridae Infections/virology , Enterovirus , Gastroenteritis/epidemiology , Gastroenteritis/virology , Norovirus , Caliciviridae Infections/epidemiology , Enterovirus Infections/epidemiology , Enterovirus Infections/virology , Humans , Incidence , SARS-CoV-2 , Victoria/epidemiology
9.
Seizure ; 84: 69-77, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1065589

ABSTRACT

OBJECTIVE: There are limited data on the pathogen-related and host-related factors in the pathogenesis of febrile seizures (FS). We designed a controlled study to compare the role of different respiratory viruses and febrile response in FS. METHODS: In a prospective cohort study of 1899 pediatric emergency room patients aged 6 months-6 years with a positive respiratory virus multiplex PCR, we identified 225 patients with FSs. We first compared the distribution of respiratory viruses in age-stratified patients with FSs with that in other patients. In an embedded case-control study, we compared the febrile response in patients with FSs with that in the controls matched for age, season and the same respiratory virus. RESULTS: The relative risk for FS was the highest for coronavirus OC43, 229E, and NL63 infections [RR: 3.2, 95 % confidence interval (CI): 1.4-7.2) and influenza A and B [RR: 2.5, 95 % CI: 1.4-4.7] as compared to those with other respiratory viral infections. The patients with FSs had a stronger febrile response of 39.2 °C (difference: 0.8 °C, 95 % CI: 0.5-1.2) later during hospitalization after acute care than the controls matched for the same respiratory virus. CONCLUSIONS: Influenza and coronaviruses caused relatively more FS-related emergency room visits than other respiratory viruses. Furthermore, the febrile response was stronger in the patients with FSs than in the controls matched for the same respiratory virus. The results suggest that the pathomechanism of FSs includes modifiable pathogen-related and host-related factors with possible potential in the prevention of FSs.


Subject(s)
Coronavirus Infections/epidemiology , Enterovirus Infections/epidemiology , Influenza, Human/epidemiology , Paramyxoviridae Infections/epidemiology , Respiratory Tract Infections/epidemiology , Seizures, Febrile/epidemiology , Adenovirus Infections, Human/epidemiology , Adenovirus Infections, Human/virology , Case-Control Studies , Child , Child, Preschool , Cohort Studies , Coronavirus 229E, Human , Coronavirus Infections/virology , Coronavirus NL63, Human , Coronavirus OC43, Human , Emergency Service, Hospital , Enterovirus Infections/virology , Female , Fever/physiopathology , Finland/epidemiology , Humans , Infant , Inflammation , Influenza A virus , Influenza B virus , Influenza, Human/virology , Male , Multiplex Polymerase Chain Reaction , Paramyxoviridae Infections/virology , Picornaviridae Infections/epidemiology , Picornaviridae Infections/virology , Prospective Studies , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/virology , Respiratory Tract Infections/physiopathology , Respiratory Tract Infections/virology , Rhinovirus , Risk , Seizures, Febrile/virology
12.
Emerg Infect Dis ; 27(1)2021 01.
Article in English | MEDLINE | ID: covidwho-954025

ABSTRACT

In Taiwan, lower nonpolio enterovirus activity during the coronavirus disease pandemic in 2020 compared with 2014-2019 might be attributable to adherence to nonpharmaceutical interventions. The preventable fraction among unexposed persons indicated that 90% of nonpolio enterovirus activity might have been prevented during 2014-2019 by adopting the same measures enforced in 2020.


Subject(s)
COVID-19/epidemiology , Enterovirus Infections/epidemiology , Enterovirus/physiology , SARS-CoV-2 , Adolescent , Child , Child, Preschool , Humans , Infant , Taiwan/epidemiology
13.
Pediatr Infect Dis J ; 39(8): 687-693, 2020 08.
Article in English | MEDLINE | ID: covidwho-913268

ABSTRACT

BACKGROUND: Acute lower respiratory tract infections (ALRIs) are the most common disease for hospitalized children in Japan. The aim of this study was to identify viruses in children hospitalized for ALRIs and to demonstrate epidemiologic and clinical characteristics in Japan. METHODS: During a 2-year period from February 2013 to January 2015, we collected nasopharyngeal swab specimens from almost all hospitalized children with ALRIs in Nagasaki, a regional city of Japan, and its environs. Viruses were detected by multiplex polymerase chain reaction from these samples. RESULTS: We detected one or more viruses from 259 (69%) of 374 patients, 227 of whom were infected with a single virus, 30 with 2, and 2 with 3 viruses. Detected viruses in this study were rhinovirus (46.4%), respiratory syncytial virus (29.7%), human metapneumovirus (6.8%), parainfluenza virus (5.5%), enterovirus D68 (3.4%), influenza virus (2.7%), adenovirus (2.4%), bocavirus (2.0%) and Coxsackie virus (1.0%). We detected a seasonal shift in respiratory syncytial virus outbreaks from the 2013-2014 to the 2014-2015 seasons. There was no significant difference in clinical course and severity among those viruses. Patients with a history of asthma or underlying diseases were older and more frequently required oxygen therapy than previously healthy patients. CONCLUSIONS: Viral etiology in hospitalized children with ALRIs in Nagasaki, Japan, was similar to that in many other countries. Enterovirus D68, which was recently recognized as a causative agent of severe ALRIs, was also identified in this study area. Severity of ALRIs may depend on underlying disease rather than type of etiologic virus.


Subject(s)
Hospitalization/statistics & numerical data , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Virus Diseases/epidemiology , Viruses/isolation & purification , Acute Disease , Child, Preschool , Cities/epidemiology , Coinfection/epidemiology , Coinfection/virology , Enterovirus D, Human/genetics , Enterovirus Infections/epidemiology , Female , Humans , Infant , Japan/epidemiology , Male , Nasopharynx/virology , Prospective Studies , Seasons , Viruses/classification , Viruses/genetics
14.
J Med Internet Res ; 22(8): e21257, 2020 08 20.
Article in English | MEDLINE | ID: covidwho-836108

ABSTRACT

BACKGROUND: The coronavirus disease (COVID-19) pandemic is an important health crisis worldwide. Several strategies were implemented to combat COVID-19, including wearing masks, hand hygiene, and social distancing. The impact of these strategies on COVID-19 and other viral infections remains largely unclear. OBJECTIVE: We aim to investigate the impact of implemented infectious control strategies on the incidences of influenza, enterovirus infection, and all-cause pneumonia during the COVID-19 pandemic. METHODS: We utilized the electronic database of the Taiwan National Infectious Disease Statistics System and extracted incidences of COVID-19, influenza virus, enterovirus, and all-cause pneumonia. We compared the incidences of these diseases from week 45 of 2016 to week 21 of 2020 and performed linear regression analyses. RESULTS: The first case of COVID-19 in Taiwan was reported in late January 2020 (week 4). Infectious control strategies have been promoted since late January. The influenza virus usually peaks in winter and decreases around week 14. However, a significant decrease in influenza was observed after week 6 of 2020. Regression analyses produced the following results: 2017, R2=0.037; 2018, R2=0.021; 2019, R2=0.046; and 2020, R2=0.599. A dramatic decrease in all-cause pneumonia was also reported (R2 values for 2017-2020 were 0.435, 0.098, 0.352, and 0.82, respectively). Enterovirus had increased by week 18 in 2017-2019, but this was not observed in 2020. CONCLUSIONS: Using this national epidemiological database, we found a significant decrease in cases of influenza, enterovirus, and all-cause pneumonia during the COVID-19 pandemic. Wearing masks, hand hygiene, and social distancing may contribute not only to the prevention of COVID-19 but also to the decline of other respiratory infectious diseases. Further studies are warranted to elucidate the causal relationship.


Subject(s)
Betacoronavirus/pathogenicity , COVID-19/prevention & control , Coronavirus Infections/prevention & control , Coronavirus/pathogenicity , Enterovirus Infections/prevention & control , Hand Hygiene/methods , Infection Control/methods , Influenza, Human/prevention & control , Masks/trends , Pandemics/prevention & control , Pneumonia/prevention & control , COVID-19/psychology , Coronavirus Infections/psychology , Enterovirus Infections/epidemiology , Humans , Incidence , Influenza, Human/epidemiology , Physical Distancing , Pneumonia/epidemiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Retrospective Studies , SARS-CoV-2
16.
Emerg Infect Dis ; 26(10): 2509-2511, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-690723

ABSTRACT

To determine whether policies to limit transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) hinder spread of other infectious diseases, we analyzed the National Health Insurance database in Taiwan. Rates of other infections were significantly lower after SARS-CoV-2 prevention measures were announced. This finding can be applied to cost-effectiveness of SARS-CoV-2 prevention.


Subject(s)
Ambulatory Care/statistics & numerical data , Coronavirus Infections/prevention & control , Enterovirus Infections/epidemiology , Influenza, Human/epidemiology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Scarlet Fever/epidemiology , Betacoronavirus , COVID-19 , Databases, Factual , Health Policy , Humans , SARS-CoV-2 , Taiwan/epidemiology
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