Twenty-nine Cases of Enterovirus-D68-associated Acute Flaccid Myelitis in Europe 2016 : A Case Series and Epidemiologic Overview
BACKGROUND: Enterovirus-D68 (EV-D68) is a respiratory virus within the genus Enterovirus and the family of Picornaviridae. Genetically, it is closely related to rhinovirus that replicates in the respiratory tract and causes respiratory disease. Since 2014, EV-D68 has been associated with the neurologic syndrome of acute flaccid myelitis (AFM).
METHODS: In October 2016, questionnaires were sent out to a European network including 66 virologists and clinicians, to develop an inventory of EV-D68-associated AFM cases in Europe. Clinical and virologic information of case patients was requested. In addition, epidemiologic information on EV testing was collected for the period between March and October 2016.
RESULTS: Twenty-nine cases of EV-D68-associated AFM were identified, from 12 different European countries. Five originated from France, 5 from Scotland and 3 each from Sweden, Norway and Spain. Twenty-six were children (median age 3.8 years), 3 were adults. EV-D68 was detected in respiratory materials (n = 27), feces (n = 8) and/or cerebrospinal fluid (n = 2). Common clinical features were asymmetric flaccid limb weakness, cranial nerve deficits and bulbar symptoms. On magnetic resonance imaging, typical findings were hyperintensity of the central cord and/or brainstem; low motor amplitudes with normal conduction velocities were seen on electromyography. Full clinical recovery was rare (n = 3), and 2 patients died. The epidemiologic data from 16 European laboratories showed that of all EV-D68-positive samples, 99% was detected in a respiratory specimen.
CONCLUSIONS: For 2016, 29 EV-D68-related AFM cases were identified in mostly Western Europe. This is likely an underestimation, because case identification is dependent on awareness among clinicians, adequate viral diagnostics on respiratory samples and the capability of laboratories to type EVs.
| Errataetall: |
CommentIn: Pediatr Infect Dis J. 2019 Oct;38(10):e277. - PMID 31261351 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
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| Enthalten in: |
The Pediatric infectious disease journal - 38(2019), 1 vom: 01. Jan., Seite 16-21 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Knoester, Marjolein [VerfasserIn] |
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Date Completed 04.02.2020 Date Revised 26.03.2020 published: Print CommentIn: Pediatr Infect Dis J. 2019 Oct;38(10):e277. - PMID 31261351 Citation Status MEDLINE |
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| doi: |
10.1097/INF.0000000000002188 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM288713931 |
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| 041 | |a eng | ||
| 100 | 1 | |a Knoester, Marjolein |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Twenty-nine Cases of Enterovirus-D68-associated Acute Flaccid Myelitis in Europe 2016 |b A Case Series and Epidemiologic Overview |
| 264 | 1 | |c 2019 | |
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| 500 | |a Date Completed 04.02.2020 | ||
| 500 | |a Date Revised 26.03.2020 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Pediatr Infect Dis J. 2019 Oct;38(10):e277. - PMID 31261351 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Enterovirus-D68 (EV-D68) is a respiratory virus within the genus Enterovirus and the family of Picornaviridae. Genetically, it is closely related to rhinovirus that replicates in the respiratory tract and causes respiratory disease. Since 2014, EV-D68 has been associated with the neurologic syndrome of acute flaccid myelitis (AFM) | ||
| 520 | |a METHODS: In October 2016, questionnaires were sent out to a European network including 66 virologists and clinicians, to develop an inventory of EV-D68-associated AFM cases in Europe. Clinical and virologic information of case patients was requested. In addition, epidemiologic information on EV testing was collected for the period between March and October 2016 | ||
| 520 | |a RESULTS: Twenty-nine cases of EV-D68-associated AFM were identified, from 12 different European countries. Five originated from France, 5 from Scotland and 3 each from Sweden, Norway and Spain. Twenty-six were children (median age 3.8 years), 3 were adults. EV-D68 was detected in respiratory materials (n = 27), feces (n = 8) and/or cerebrospinal fluid (n = 2). Common clinical features were asymmetric flaccid limb weakness, cranial nerve deficits and bulbar symptoms. On magnetic resonance imaging, typical findings were hyperintensity of the central cord and/or brainstem; low motor amplitudes with normal conduction velocities were seen on electromyography. Full clinical recovery was rare (n = 3), and 2 patients died. The epidemiologic data from 16 European laboratories showed that of all EV-D68-positive samples, 99% was detected in a respiratory specimen | ||
| 520 | |a CONCLUSIONS: For 2016, 29 EV-D68-related AFM cases were identified in mostly Western Europe. This is likely an underestimation, because case identification is dependent on awareness among clinicians, adequate viral diagnostics on respiratory samples and the capability of laboratories to type EVs | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Helfferich, Jelte |e verfasserin |4 aut | |
| 700 | 1 | |a Poelman, Randy |e verfasserin |4 aut | |
| 700 | 1 | |a Van Leer-Buter, Coretta |e verfasserin |4 aut | |
| 700 | 1 | |a Brouwer, Oebele F |e verfasserin |4 aut | |
| 700 | 1 | |a Niesters, Hubert G M |e verfasserin |4 aut | |
| 700 | 0 | |a 2016 EV-D68 AFM Working Group |e verfasserin |4 aut | |
| 700 | 1 | |a Aberle, Stephan W |e investigator |4 oth | |
| 700 | 1 | |a Popow-Kraupp, Theresia |e investigator |4 oth | |
| 700 | 1 | |a Nikolaeva-Glomb, Lubomira |e investigator |4 oth | |
| 700 | 1 | |a Rainetova, Petra |e investigator |4 oth | |
| 700 | 1 | |a Midgley, Sofie |e investigator |4 oth | |
| 700 | 1 | |a Fischer, Thea Kølsen |e investigator |4 oth | |
| 700 | 1 | |a Simonlatser, Grethel |e investigator |4 oth | |
| 700 | 1 | |a Savolainen-Kopra, Carita |e investigator |4 oth | |
| 700 | 1 | |a Lina, Bruno |e investigator |4 oth | |
| 700 | 1 | |a Schuffenecker, Isabelle |e investigator |4 oth | |
| 700 | 1 | |a Kossorotoff, Manoëlle |e investigator |4 oth | |
| 700 | 1 | |a Antona, Denise |e investigator |4 oth | |
| 700 | 1 | |a Eis-Hübinger, Anna Maria |e investigator |4 oth | |
| 700 | 1 | |a Buderus, Stephan |e investigator |4 oth | |
| 700 | 1 | |a Panning, Marcus |e investigator |4 oth | |
| 700 | 1 | |a Nowotny, Markus |e investigator |4 oth | |
| 700 | 1 | |a Kiechle, Lisa |e investigator |4 oth | |
| 700 | 1 | |a Böttcher, Sindy |e investigator |4 oth | |
| 700 | 1 | |a Takács, Mária |e investigator |4 oth | |
| 700 | 1 | |a Farkas, Ágnes |e investigator |4 oth | |
| 700 | 1 | |a Löve, Arthur |e investigator |4 oth | |
| 700 | 1 | |a Baldanti, Fausto |e investigator |4 oth | |
| 700 | 1 | |a Piralla, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Capobianchi, Maria Rosaria |e investigator |4 oth | |
| 700 | 1 | |a Valli, Maria Beatrice |e investigator |4 oth | |
| 700 | 1 | |a Esposito, Susanna |e investigator |4 oth | |
| 700 | 1 | |a Pariani, Elena |e investigator |4 oth | |
| 700 | 1 | |a Binda, Sandro |e investigator |4 oth | |
| 700 | 1 | |a Neuteboom, Rinze |e investigator |4 oth | |
| 700 | 1 | |a Pas, Suzan |e investigator |4 oth | |
| 700 | 1 | |a Benschop, Kimberley |e investigator |4 oth | |
| 700 | 1 | |a Meijer, Adam |e investigator |4 oth | |
| 700 | 1 | |a Nordbø, Svein Arne |e investigator |4 oth | |
| 700 | 1 | |a Hafstrøm, Maria |e investigator |4 oth | |
| 700 | 1 | |a Dudman, Susanne Gjeruldsen |e investigator |4 oth | |
| 700 | 1 | |a Pfeiffer, Helle |e investigator |4 oth | |
| 700 | 1 | |a Guiomar, Raquel |e investigator |4 oth | |
| 700 | 1 | |a Palminha, Paula |e investigator |4 oth | |
| 700 | 1 | |a Costa, Inês |e investigator |4 oth | |
| 700 | 1 | |a Dias, Andrea Sofia |e investigator |4 oth | |
| 700 | 1 | |a Tecu, Cristina |e investigator |4 oth | |
| 700 | 1 | |a Cherciu, Carmen Maria |e investigator |4 oth | |
| 700 | 1 | |a Lazarevic, Ivana |e investigator |4 oth | |
| 700 | 1 | |a Filipović – Vignjević, Svetlana |e investigator |4 oth | |
| 700 | 1 | |a Berginc, Natasa |e investigator |4 oth | |
| 700 | 1 | |a Margüello, Mónica Gozalo |e investigator |4 oth | |
| 700 | 1 | |a Cabrerizo, Maria |e investigator |4 oth | |
| 700 | 1 | |a García-Iñiguez, Juan Pablo |e investigator |4 oth | |
| 700 | 1 | |a Perez-Castro, Sonia |e investigator |4 oth | |
| 700 | 1 | |a Rodrigo, Carlos |e investigator |4 oth | |
| 700 | 1 | |a Antón, Andrés |e investigator |4 oth | |
| 700 | 1 | |a Rabella, Núria |e investigator |4 oth | |
| 700 | 1 | |a Dyrdak, Robert |e investigator |4 oth | |
| 700 | 1 | |a Albert, Jan |e investigator |4 oth | |
| 700 | 1 | |a Kramer, Rolf |e investigator |4 oth | |
| 700 | 1 | |a Stacpoole, Sybil |e investigator |4 oth | |
| 700 | 1 | |a Thomas, Rhys |e investigator |4 oth | |
| 700 | 1 | |a O’Flaherty, Niamh |e investigator |4 oth | |
| 700 | 1 | |a Drew, Richard |e investigator |4 oth | |
| 700 | 1 | |a Templeton, Kate |e investigator |4 oth | |
| 700 | 1 | |a McDougall, Catherine |e investigator |4 oth | |
| 700 | 1 | |a Eunson, Paul |e investigator |4 oth | |
| 700 | 1 | |a Chinchankar, Nandita |e investigator |4 oth | |
| 700 | 1 | |a Shetty, Jay |e investigator |4 oth | |
| 700 | 1 | |a Moore, Catherine |e investigator |4 oth | |
| 700 | 1 | |a Williams, Christopher |e investigator |4 oth | |
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