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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.
CDC Emerging Infectious Diseases Journal published a clinical update in Infectious Disease on 07 Apr 2026.
The item focuses on Circulation Patterns, Genetic Diversity, and Public Health Implications of Enterovirus D68, Europe, 2014–2024.
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