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Enterovirus D68 Subclade B3 Strain Circulating and Causing an Outbreak in the United States in 2016
Guiqing Wang1,2, Jian Zhuge3, Weihua Huang4
1Department of Pathology, New York Medical College, Valhalla, New York, USA. guiqing_wang@nymc.edu.
Abstract:
In 2014 the United States experienced a nationwide outbreak of Enterovirus D68 (EV-D68) infection. There were no confirmed cases of EV-D68 in 2015 and CDC was only aware of limited sporadic EV-D68 detection in the US in 2016. In this report, we analyzed 749 nasopharyngeal (NP) specimens collected in 2015 and 2016 from patients in the Lower Hudson Valley, New York using a previously validated EV-D68-specific rRT-PCR assay. EV-D68 was detected in none of 199 NP specimens collected in 2015, and in one of 108 (0.9%) samples from January to May and 159 of 442 (36.0%) samples from July to October 2016. Complete EV-D68 genome sequences from 22 patients in 2016 were obtained using a metagenomic next-generation sequencing assay. Comparative genome analysis confirmed that a new EV-D68 strain belonging to subclade B3, with 3.2-4.8% divergence in nucleotide from subclade B1 strains identified during the 2014 US outbreak, was circulating in the US in 2016 and caused an outbreak in the Lower Hudson Valley, New York with 160 laboratory-confirmed cases. Our data highlight the genetic variability and capacity in causing outbreak by diverse EV-D68 strains, and the necessity of awareness and more surveillance on their active circulation worldwide.
Insights
Enterovirus D68 (EV-D68) re-emerged in 2016 with a new B3 subclade strain causing an outbreak in New York. This highlights the genetic diversity and outbreak potential of EV-D68 strains, necessitating global surveillance.
Area of Science:
- Virology
- Epidemiology
- Genomics
Background:
- The United States experienced a nationwide Enterovirus D68 (EV-D68) outbreak in 2014.
- Limited EV-D68 detection was reported in 2015 and 2016.
- EV-D68 is a significant respiratory pathogen.
Purpose of the Study:
- To analyze the prevalence and genetic characteristics of EV-D68 in the Lower Hudson Valley, New York, during 2015-2016.
- To identify the circulating EV-D68 strain and its genetic relationship to previous strains.
Main Methods:
- Analysis of 749 nasopharyngeal specimens collected in 2015-2016 using EV-D68-specific real-time reverse transcription polymerase chain reaction (rRT-PCR).
- Whole-genome sequencing of detected EV-D68 strains using metagenomic next-generation sequencing.
- Comparative genomic analysis to determine strain lineage and divergence.
Main Results:
- No EV-D68 detected in 199 specimens from 2015.
- EV-D68 detected in 0.9% of samples from January-May 2016 and 36.0% from July-October 2016.
- A novel EV-D68 strain (subclade B3) was identified, causing 160 confirmed cases in a 2016 outbreak.
- The new strain showed 3.2-4.8% nucleotide divergence from the 2014 B1 subclade strains.
Conclusions:
- A new EV-D68 subclade B3 strain emerged and caused a significant outbreak in New York in 2016.
- EV-D68 strains exhibit genetic variability and the potential for recurrent outbreaks.
- Enhanced global surveillance is crucial for monitoring the circulation of diverse EV-D68 strains.
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