{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:54:30Z","timestamp":1790463270716,"version":"4.1.0"},"reference-count":52,"publisher":"Microbiology Society","issue":"5","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,27]]},"abstract":"<jats:p>\n                    Enterovirus D68 (EV-D68) has recently been identified in biennial epidemics coinciding with diagnoses of non-polio acute flaccid paralysis\/myelitis (AFP\/AFM). We investigated the prevalence, genetic relatedness and associated clinical features of EV-D68 in 193\u2009EV-positive samples from 193\u2009patients in late 2018, UK. EV-D68 was detected in 83 (58\u200a%) of 143 confirmed EV-positive samples. Sequencing and phylogenetic analysis revealed extensive genetic diversity, split between subclades B3 (\n                    <jats:italic>n<\/jats:italic>\n                    =50) and D1 (\n                    <jats:italic>n<\/jats:italic>\n                    =33), suggesting epidemiologically unrelated infections. B3 predominated in children and younger adults, and D1 in older adults and the elderly (\n                    <jats:italic>P<\/jats:italic>\n                    =0.0009). Clinical presentation indicated causation or exacerbation of respiratory distress in 91.4\u200a% of EV-D68-positive individuals, principally cough (75.3\u200a%), shortness of breath (56.8\u200a%), coryza (48.1\u200a%), wheeze (46.9\u200a%), supplemental oxygen required (46.9\u200a%) and fever (38.9\u200a%). Two cases of AFM were observed, one with EV-D68 detectable in the cerebrospinal fluid, but otherwise neurological symptoms were rarely reported (\n                    <jats:italic>n<\/jats:italic>\n                    =4). Both AFM cases and all additional instances of intensive care unit (ICU) admission (\n                    <jats:italic>n<\/jats:italic>\n                    =5) were seen in patients infected with EV-D68 subclade B3. However, due to the infrequency of severe infection in our cohort, statistical significance could not be assessed.\n                  <\/jats:p>","DOI":"10.1099\/mgen.0.000825","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T08:15:50Z","timestamp":1652084150000},"source":"Crossref","is-referenced-by-count":12,"title":["Enterovirus D68 epidemic, UK, 2018, was caused by subclades B3 and D1, predominantly in children and adults, respectively, with both subclades exhibiting extensive genetic diversity"],"prefix":"10.1099","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1086-5692","authenticated-orcid":false,"given":"Hannah C.","family":"Howson-Wells","sequence":"first","affiliation":[{"name":"Clinical Microbiology, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9685-6318","authenticated-orcid":false,"given":"Theocharis","family":"Tsoleridis","sequence":"additional","affiliation":[{"name":"Wolfson Centre for Global Virus Research, University of Nottingham, Nottingham, UK"},{"name":"School of Life Sciences, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izzah","family":"Zainuddin","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1009-0823","authenticated-orcid":false,"given":"Alexander W.","family":"Tarr","sequence":"additional","affiliation":[{"name":"Wolfson Centre for Global Virus Research, University of Nottingham, Nottingham, UK"},{"name":"School of Life Sciences, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William L.","family":"Irving","sequence":"additional","affiliation":[{"name":"Wolfson Centre for Global Virus Research, University of Nottingham, Nottingham, UK"},{"name":"School of Life Sciences, University of Nottingham, Nottingham, UK"},{"name":"Clinical Microbiology, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan K.","family":"Ball","sequence":"additional","affiliation":[{"name":"Wolfson Centre for Global Virus Research, University of Nottingham, Nottingham, UK"},{"name":"School of Life Sciences, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Berry","sequence":"additional","affiliation":[{"name":"School of Life Sciences, University of Nottingham, Nottingham, UK"},{"name":"Clinical Microbiology, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Clark","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1710-1049","authenticated-orcid":false,"given":"C. Patrick","family":"McClure","sequence":"additional","affiliation":[{"name":"School of Life Sciences, University of Nottingham, Nottingham, UK"},{"name":"Wolfson Centre for Global Virus Research, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1007\/s00705-019-04520-6"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30566-3"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1126\/science.aat6777"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)70093-9"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2017.00257"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62457-0"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14096"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1038\/srep25147"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004416"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.01954-18"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1006199"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.3390\/v10020058"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.02370-19"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piy124"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1099\/vir.0.79925-0"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2015.06.079"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.82a.14166"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2020.25.2.1900749"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2018.24.7.1900090"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2019.24.3.1800699"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2018.23.37.1700711"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2018.01.005"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.3390\/v13081607"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.3201\/eid2506.181759"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.3201\/eid2503.180960"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.01903-19"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0613-1"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2018.01.008"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.02262-18"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.3201\/eid2511.190973"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00542-06"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.80.1.483-493.2006"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104646"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2007.11.016"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2011.03.006"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.1093\/molbev\/msaa015"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2021.104880"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30852-5"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268817000590"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.abd2400"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2019.24.6.1900093"},{"key":"R42","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2018.23.46.1800578"},{"key":"R43","article-title":"A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts","author":"Hayes","year":"2019","journal-title":"J Med Virol"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.1101\/2020.01.10.901553"},{"key":"R45","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-24566-y"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.1126\/science.aag1322"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001421"},{"key":"R48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0184335"},{"key":"R49","doi-asserted-by":"publisher","DOI":"10.1093\/ve\/vew015"},{"key":"R50","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix860"},{"key":"R51","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2018.01956"},{"key":"R52","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2016.11.013"}],"container-title":["Microbial Genomics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/mgen\/10.1099\/mgen.0.000825?crawler=true&mimetype=application\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T14:36:32Z","timestamp":1702564592000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/mgen\/10.1099\/mgen.0.000825"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,27]]},"references-count":52,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5,27]]}},"URL":"https:\/\/doi.org\/10.1099\/mgen.0.000825","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.12.09.21267508","asserted-by":"object"}]},"ISSN":["2057-5858"],"issn-type":[{"value":"2057-5858","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,27]]}}}