Infection with enterovirus D68 (EV-D68) has been linked with severe neurological disease such as acute flaccid myelitis (AFM) in recent years. However, active surveillance for EV-D68 is lacking, which makes full assessment of this association difficult. Although a high number of EV-D68 infections were expected in 2020 based on the EV-D68′s known biannual circulation patterns, no apparent increase in EV-D68 detections or AFM cases was observed during 2020. We describe an upsurge of EV-D68 detections in wastewater samples from the United Kingdom between July and November 2021 mirroring the recently reported rise in EV-D68 detections in clinical samples from various European countries. We provide the first publicly available 2021 EV-D68 sequences showing co-circulation of EV-D68 strains from genetic clade D and sub-clade B3 as in previous years. Our results show the value of environmental surveillance (ES) for the early detection of circulating and clinically relevant human viruses. The use of a next-generation sequencing (NGS) approach helped us to estimate the prevalence of EV-D68 viruses among EV strains from other EV serotypes and to detect EV-D68 minor variants. The utility of ES at reducing gaps in virus surveillance for EV-D68 and the possible impact of nonpharmaceutical interventions introduced to control the COVID-19 pandemic on EV-D68 transmission dynamics are discussed.
【저자키워드】 COVID-19 pandemic, wastewater, Direct detection, Environmental surveillance, next-generation sequencing (NGS), human enterovirus D68, acute flaccid myelitis (AFM), 【초록키워드】 viruses, NGS, Genetic, Infection, virus, variants, Prevalence, Surveillance, Next-generation sequencing, Transmission dynamics, Active surveillance, clade, circulation, utility, United Kingdom, association, nonpharmaceutical intervention, strain, AFM, Neurological disease, serotype, sequence, circulating, Enterovirus D68, approach, European, clinical sample, detect, reported, clinically, introduced, reducing, increase in, expected, 【제목키워드】 detection, enterovirus, Sample,