Epidemiological and Clinical Insights into Enterovirus Circulation in Europe, 2018–2023: A Multicenter Retrospective Surveillance Study - Scorecard - MDSpire

Epidemiological and Clinical Insights into Enterovirus Circulation in Europe, 2018–2023: A Multicenter Retrospective Surveillance Study

  • By

  • Sten de Schrijver

  • Emiel Vanhulle

  • Anne Ingenbleek

  • Leonidas Alexakis

  • Caroline Klint Johannesen

  • Eeva K Broberg

  • Heli Harvala

  • Thea K Fischer

  • Kimberley S M Benschop

  • on behalf of

  • ENPEN Study Collaborators

  • Jan Albert

  • Nancy Allen

  • Laurent Andreoletti

  • Sowsan Atabani

  • Christelle Auvray

  • Aldert Bart

  • Carla Berengua

  • Natasa Berginc

  • Maxime Bisseux

  • Hanneke Boon

  • Ana Bordes-Benitez

  • Andrew Bosworth

  • Sindy Böttcher

  • Maria Cabrerizo

  • Annapaola Callegaro

  • Cristina Calvo

  • Benjamin Canning

  • Marianne Coste-Burel

  • Karen Couderé

  • Jean-Marie Delarbre

  • Sabine Diedrich

  • Susanne Dudman

  • Robert Dyrdak

  • Julien Exinger

  • Eric Farfour

  • Maria Dolores Fernandez-Garcia

  • Jacky Flipse

  • Vincent Foulongne

  • Kristina Træholt Franck

  • Floriane Gallais

  • Magali Garcia

  • Irina Georgieva

  • Géraldine Gonfrier

  • Clémence Guillaume

  • Almudena Gutierrez-Arroyo

  • Cécile Henquell

  • Marijke Hooghiemstra

  • Elisabeth Huijskens

  • Anne J Jääskeläinen

  • Marion Jeannoël

  • Marine Jourdain

  • Elisabeth Toverud Landaas

  • Kathrin Keeren

  • Eduardo Lagarejos

  • Gisèle Lagathu

  • Sylvie Larrat

  • Cristian Launes

  • Mouna Lazrek

  • Caroline Lefeuvre

  • Véronique Lemée

  • Quentin Lepiller

  • Marianne Leruez

  • David Leyssene

  • Anne Sophie L'Honneur

  • Bruno Lina

  • Marie Louchet Ducoroy

  • Maja M Lunar

  • Jean-Michel Mansuy

  • Stéphanie Marque Julliet

  • Gina Mcallister

  • C Patrick McClure

  • Antonio Medina-Claros

  • Gregoria Megias

  • Sofie Elisabeth Midgley

  • Audrey Mirand

  • Richard Molenkamp

  • Milagrosa Montes

  • Antonio Moreno-Docón

  • Carmen Munoz-Almagro

  • Jean-Benjamin Murat

  • Jean-Luc Murk

  • Ana Navascues-Ortega

  • Maria Carmen Nieto-Toboso

  • Laetitia Ninove

  • Marije Oosting

  • Eider Oñate

  • Jordi Pacaud

  • Coralie Pallier

  • Elena Pariani

  • Laura Pellegrinelli

  • Mercedes Pérez-Ruiz

  • Sylvie Pillet

  • Léa Pilorgé

  • Luis Piñeiro

  • Mario Poljak

  • Birgit Prochazka

  • Emeline Riverain

  • Sylvie Rogez

  • Maud Salmona

  • Kenda Saloum

  • Erik Schaftenaar

  • Cécile Schanen

  • Manuel Schibler

  • Isabelle Schuffenecker

  • Karl Stefic

  • Petri Susi

  • Caroline M A Swanink

  • Charlotte Tellini

  • Anne Lise Toyer

  • Sara Colonia Uceda Renteria

  • Juan Valencia-Ramos

  • Freek B van Loenen

  • Inge van Loo

  • Véronique Venard

  • Jaco J Verweij

  • Karin J von Eije

  • Tytti Vuorinen

  • Elke Wollants

  • Laura Zanetti

  • April 4, 2025

  • 0 min

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Clinical Scorecard: Clinical and Epidemiological Analysis of Enterovirus Activity in Europe from 2018 to 2023: A Retrospective Multicenter Surveillance Study

At a Glance

CategoryDetail
ConditionEnterovirus infections causing outbreaks with severe clinical manifestations including neurological and respiratory illnesses
Key MechanismsTransmission primarily via fecal-oral and respiratory routes; diverse EV types with varying clinical presentations
Target PopulationPredominantly neonates and young children
Care SettingHospital settings across multiple European countries

Key Highlights

  • 563,654 clinical samples tested with 5.9% EV positivity; 42 EV types identified with E30, CVA6, EV-D68 among most frequent
  • Post-COVID-19 pandemic shifts observed in EV type prevalence, seasonality (summer to fall), and specimen positivity (feces to respiratory)
  • Neurological signs predominated in several EV types; paralysis reported in 22 infections associated with 10 nonpolio EV types

Guideline-Based Recommendations

Diagnosis

  • Use VP1 sequencing as the common method for EV typing
  • Collect data on specimen type, patient age, and clinical presentation for accurate surveillance

Management

  • Monitor clinical presentations including hand, foot and mouth disease, respiratory infections, neurological signs, and paralysis
  • Focus on neonates and young children who are at higher risk for severe outcomes

Monitoring & Follow-up

  • Implement continuous and standardized EV surveillance across Europe to monitor circulation and disease burden
  • Track seasonal and epidemiological shifts in EV types and clinical manifestations

Risks

  • Severe clinical outcomes including meningitis, myocarditis, hepatitis, and paralysis especially in neonates and young children
  • Emergence and re-emergence of specific EV types post-pandemic with potential for outbreaks

Patient & Prescribing Data

Neonates and young children predominantly affected by severe EV infections

No specific antiviral treatment detailed; emphasis on surveillance and clinical monitoring to guide management

Clinical Best Practices

  • Standardize data collection and reporting through networks like ENPEN for consistent surveillance
  • Use molecular typing methods such as VP1 sequencing for accurate EV identification
  • Recognize and monitor neurological and respiratory symptoms as key clinical presentations
  • Be vigilant for paralysis and severe manifestations in nonpolio EV infections
  • Adapt surveillance strategies to account for shifts in seasonality and specimen positivity patterns

References

Original Source(s)

Epidemiological and Clinical Insights into Enterovirus Circulation in Europe, 2018–2023: A Multicenter Retrospective Surveillance Study

  • by Sten de Schrijver, Emiel Vanhulle, Anne Ingenbleek, Leonidas Alexakis, Caroline Klint Johannesen, Eeva K Broberg, Heli Harvala, Thea K Fischer, Kimberley S M Benschop, on behalf of, ENPEN Study Collaborators, Jan Albert, Nancy Allen, Laurent Andreoletti, Sowsan Atabani, Christelle Auvray, Aldert Bart, Carla Berengua, Natasa Berginc, Maxime Bisseux, Hanneke Boon, Ana Bordes-Benitez, Andrew Bosworth, Sindy Böttcher, Maria Cabrerizo, Annapaola Callegaro, Cristina Calvo, Benjamin Canning, Marianne Coste-Burel, Karen Couderé, Jean-Marie Delarbre, Sabine Diedrich, Susanne Dudman, Robert Dyrdak, Julien Exinger, Eric Farfour, Maria Dolores Fernandez-Garcia, Jacky Flipse, Vincent Foulongne, Kristina Træholt Franck, Floriane Gallais, Magali Garcia, Irina Georgieva, Géraldine Gonfrier, Clémence Guillaume, Almudena Gutierrez-Arroyo, Cécile Henquell, Marijke Hooghiemstra, Elisabeth Huijskens, Anne J Jääskeläinen, Marion Jeannoël, Marine Jourdain, Elisabeth Toverud Landaas, Kathrin Keeren, Eduardo Lagarejos, Gisèle Lagathu, Sylvie Larrat, Cristian Launes, Mouna Lazrek, Caroline Lefeuvre, Véronique Lemée, Quentin Lepiller, Marianne Leruez, David Leyssene, Anne Sophie L'Honneur, Bruno Lina, Marie Louchet Ducoroy, Maja M Lunar, Jean-Michel Mansuy, Stéphanie Marque Julliet, Gina Mcallister, C Patrick McClure, Antonio Medina-Claros, Gregoria Megias, Sofie Elisabeth Midgley, Audrey Mirand, Richard Molenkamp, Milagrosa Montes, Antonio Moreno-Docón, Carmen Munoz-Almagro, Jean-Benjamin Murat, Jean-Luc Murk, Ana Navascues-Ortega, Maria Carmen Nieto-Toboso, Laetitia Ninove, Marije Oosting, Eider Oñate, Jordi Pacaud, Coralie Pallier, Elena Pariani, Laura Pellegrinelli, Mercedes Pérez-Ruiz, Sylvie Pillet, Léa Pilorgé, Luis Piñeiro, Mario Poljak, Birgit Prochazka, Emeline Riverain, Sylvie Rogez, Maud Salmona, Kenda Saloum, Erik Schaftenaar, Cécile Schanen, Manuel Schibler, Isabelle Schuffenecker, Karl Stefic, Petri Susi, Caroline M A Swanink, Charlotte Tellini, Anne Lise Toyer, Sara Colonia Uceda Renteria, Juan Valencia-Ramos, Freek B van Loenen, Inge van Loo, Véronique Venard, Jaco J Verweij, Karin J von Eije, Tytti Vuorinen, Elke Wollants, Laura Zanetti

  • April 4, 2025

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