Changes in transmission of Enterovirus D68 (EV-D68) in England inferred from seroprevalence data

Author:

Pons-Salort Margarita1ORCID,Lambert Ben2,Kamau Everlyn3,Pebody Richard4,Harvala Heli5,Simmonds Peter3,Grassly Nicholas C1

Affiliation:

1. MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London

2. Department of Computer Science, University of Oxford

3. Nuffield Department of Medicine, University of Oxford

4. Immunization Department, Public Health England

5. Infection and Immunity, University College of London

Abstract

The factors leading to the global emergence of Enterovirus D68 (EV-D68) in 2014 as a cause of acute flaccid myelitis (AFM) in children are unknown. To investigate potential changes in virus transmissibility or population susceptibility, we measured the seroprevalence of EV-D68-specific neutralising antibodies in serum samples collected in England in 2006, 2011, and 2017. Using catalytic mathematical models, we estimate an approximately 50% increase in the annual probability of infection over the 10-year study period, coinciding with the emergence of clade B around 2009. Despite such increase in transmission, seroprevalence data suggest that the virus was already widely circulating before the AFM outbreaks and the increase of infections by age cannot explain the observed number of AFM cases. Therefore, the acquisition of or an increase in neuropathogenicity would be additionally required to explain the emergence of outbreaks of AFM. Our results provide evidence that changes in enterovirus phenotypes cause major changes in disease epidemiology.

Funder

Wellcome Trust

Publisher

eLife Sciences Publications, Ltd

Subject

General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,General Medicine,General Neuroscience

Reference46 articles.

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3. Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide;Bian;Expert Review of Anti-Infective Therapy,2015

4. Contemporary circulating enterovirus D68 strains have acquired the capacity for viral entry and replication in human neuronal cells;Brown;MBio,2018

5. Circulation of non-polio enteroviruses in 24 EU and EEA countries between 2015 and 2017: a retrospective surveillance study;Bubba;The Lancet. Infectious Diseases,2020

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