A1 Refereed original research article in a scientific journal
Circulation Patterns, Genetic Diversity, and Public Health Implications of Enterovirus D68, Europe, 2014-2024; 
Authors: Andres, Cristina; Prats-Mendez, Ignasi; Midgley, Sofie; Berginc, Natasa; Gonzalez-Sanchez, Alejandra; Johannesen, Caroline Klint; Anton, Andres; Nadal-Baron, Patricia; Fischer, Thea K.; Harvala, Heli; Benschop, Kimberley S. M.
Publisher: Centers for Disease Control and Prevention
Publication year: 2026
Journal: Emerging Infectious Diseases
Volume: 32
Issue: 4
First page : 491
Last page: 499
ISSN: 1080-6040
eISSN: 1080-6059
DOI: https://doi.org/10.3201/eid3204.251022
Publication's open availability at the time of reporting: Open Access
Publication channel's open availability : Open Access publication channel
Web address : https://wwwnc.cdc.gov/eid/article/32/4/25-1022_article
Self-archived copy’s web address: https://pmc.ncbi.nlm.nih.gov/articles/PMC13094849/
Self-archived copy's version: Publisher`s PDF
Enterovirus D68 (EV-D68) represents a continuing public health concern, given its association with severe respiratory illness and neurologic complications. In this study, we analyzed EV-D68 circulation and genetic evolution during 2014–2024 using data from 18 countries in Europe. Of 61,297 enterovirus-positive specimens, molecular detection and viral protein 1 sequencing identified 3,541 (6%) EV-D68 cases. A biennial circulation pattern was observed; detection rates ranged from 9% in 2014 to 0.9% in 2019. The pattern was disrupted in 2020 because of measures implemented in response to the COVID-19 pandemic, but then notable increases occurred in 2021 (14%), 2022 (10.7%), and 2024 (20.6%). Subgenogroups B3 (59.8%) and A2/D (28.0%) were predominant; A2/D reemerged as dominant in 2024. Mutation analyses revealed changes in antigenic regions. Our findings underscore the persistent adaptation and resurgence of EV-D68 after COVID-19. Continued genomic surveillance is essential to monitor transmission patterns caused by antigenic changes.
Funding information in the publication:
This research was partially supported by Fondo de Investigación Sanitaria, Ministerio Español de Economía y Competitividad (grant no. FIS PI22/00023) and CIBER–Consorcio Centro de Investigación Biomédica en Red (CIBERINFEC, ISCIII–CIBER de Enfermedades Infecciosas), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, and Unión Europea–NextGenerationEU.
