Epidemiological and Clinical Characteristics of the Enterovirus D68 Outbreak in Spain in 2024
Por:
Camacho, J, García-Ibáñez, N, Fernández-García, MD, Biya, Y, de Pedro, ER, Gutiérrez, A, Nieto, MC, Ruiz-García, MM, Pastor-Fajardo, MT, Lagarejos, E, Simón, CD, Navascués, A, Moreno-Docón, A, Gozalo-Marguello, M, Berengua, C, Antequera, P, Huéscar-Pascual, MD, Calvo, C, Cabrerizo, M
Publicada:
4 abr 2026
Resumen:
Enterovirus D68 (EV-D68) is a significant cause of respiratory and neurological disease worldwide. In 2024, Spain experienced its largest recorded EV-D68 outbreak, accounting for 37.4% of all typed EV (294/892). This study describes the epidemiological, clinical, and phylogenetic features of EV-D68 infections. Unexpectedly, EV-D68 infections as it seems were more frequent in adults than in children (57.2% vs. 42.8%, p < 0.05), particularly among individuals > 60 years (38.6%). In 84.9% of cases with an EV-D68 infection, EV-D68 was the sole pathogen detected. Respiratory pathologies predominated (91.9%), with bronchospasm/wheezing episodes and bronchiolitis in children, and pneumonia and exacerbations of chronic obstructive pulmonary disease in older adults (p < 0.05). Older patients showed a more severe clinical profile than pediatric patients, including higher hospitalization rates (79% vs. 59%), longer hospital stays (mean, 10.8 vs. 4.9 days), and more comorbidities (50% vs. 31%) (p < 0.01). Phylogenetic analysis revealed two co-circulating lineages with distinct age-related tropisms: B3.3 mainly affected children (88.5%), whereas the novel A2/D1.1 infected adults predominantly (79.6%), particularly >= 60 years (49.5%) (p < 0.05). This pattern may reflect lineage-specific amino acid substitutions enhancing immune evasion. Neurological disease occurred in only three patients > 60 years infected by the A2/D1.1 lineage, which contained neurovirulent substitutions (I553L, K835E, and T860N). Results support continued genomic and clinical surveillance of EV-D68.
Filiaciones:
Camacho, J:
Inst Salud Carlos III, Natl Ctr Microbiol, Enterovirus & Viral Gastroenteritis Lab, Madrid, Spain
García-Ibáñez, N:
Inst Salud Carlos III, Natl Ctr Microbiol, Enterovirus & Viral Gastroenteritis Lab, Madrid, Spain
Fernández-García, MD:
Inst Salud Carlos III, Natl Ctr Microbiol, Enterovirus & Viral Gastroenteritis Lab, Madrid, Spain
Inst Hlth Res IdiPAZ, Translat Res Network Pediat Infect Dis RITIP, Madrid, Spain
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Biya, Y:
Inst Salud Carlos III, Natl Ctr Microbiol, Enterovirus & Viral Gastroenteritis Lab, Madrid, Spain
de Pedro, ER:
Inst Salud Carlos III, Natl Ctr Microbiol, Enterovirus & Viral Gastroenteritis Lab, Madrid, Spain
Gutiérrez, A:
Hosp Univ La Paz, Madrid, Spain
Nieto, MC:
Hosp Univ Basurto, Inst Invest Sanitaria Biobizkaia, Bilbao, Spain
Ruiz-García, MM:
Hosp Gen Univ Elche, Alicante, Spain
Pastor-Fajardo, MT:
Hosp Gen Univ Elche, Alicante, Spain
Lagarejos, E:
Hosp Univ Gran Canaria Dr Negrin, Las Palmas De Gran Canaria, Spain
Simón, CD:
Hosp Univ Gran Canaria Dr Negrin, Las Palmas De Gran Canaria, Spain
Navascués, A:
Hosp Univ Navarra, Pamplona, Spain
Moreno-Docón, A:
Hosp Clin Univ Virgen Arrixaca, Murcia, Spain
Gozalo-Marguello, M:
Hosp Univ Marques Valdecilla, Santander, Spain
Berengua, C:
Hosp Univ Santa Creu & St Pau, Barcelona, Spain
Antequera, P:
Hosp Univ JM Morales Mesenguer, Murcia, Spain
Huéscar-Pascual, MD:
Hosp Univ JM Morales Mesenguer, Murcia, Spain
Calvo, C:
Inst Hlth Res IdiPAZ, Translat Res Network Pediat Infect Dis RITIP, Madrid, Spain
Hosp Univ La Paz, Madrid, Spain
CIBERINFEC, Madrid, Spain
Cabrerizo, M:
Inst Salud Carlos III, Natl Ctr Microbiol, Enterovirus & Viral Gastroenteritis Lab, Madrid, Spain
Inst Hlth Res IdiPAZ, Translat Res Network Pediat Infect Dis RITIP, Madrid, Spain
Inst Salud Carlos III, CIBERESP, Madrid, Spain
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