Recommendations for enterovirus diagnostics and characterisation within and beyond Europe

Heli Harvala, Eeva Broberg, Kimberley Benschop, Natasa Berginc, Shamez Ladhani, Petri Susi, Claus Christiansen, James McKenna, David Allen, Phoebe Makiello, Georgina McAllister, Mirabelli Carmen, Katherina Zakikhany, Robert Dyrdak, Xiaohui Nielsen, Tina Madsen, Joel Paul, Catherine Moore, Karin von Eije, Antonio Piralla & 46 others Mieke Carlier, Laura Vanoverschelde, Randy Poelman, Andrés Anton, F. Xavier López-Labrador, Laura Pellegrinelli, Kathrin Keeren, Melanie Maier, Hayley Cassidy, Stavros Derdas, Carita Savolainen-Kopra, Sabine Diedrich, Svein Nordbø, Javier Buesa, Jean Luc Bailly, Fausto Baldanti, Andrew MacAdam, Audrey Mirand, Susanne Dudman, Isabelle Schuffenecker, Seilesh Kadambari, Johan Neyts, Michael J. Griffiths, Jan Richter, Cristina Margaretto, Sheila Govind, Ursula Morley, Ortwin Adams, Sidsel Krokstad, Jonathan Dean, Margarita Pons-Salort, Birgit Prochazka, Maria Cabrerizo, Manasi Majumdar, Gaia Nebbia, Maryse Wiewel, Simon Cottrell, Peter Coyle, Javier Martin, Catrin Moore, Sofie Midgley, Peter Horby, Katja Wolthers, Peter Simmonds, Hubert Niesters, Thea K. Fischer

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

Enteroviruses (EV) can cause severe neurological and respiratory infections, and occasionally lead to devastating outbreaks as previously demonstrated with EV-A71 and EV-D68 in Europe. However, these infections are still often underdiagnosed and EV typing data is not currently collected at European level. In order to improve EV diagnostics, collate data on severe EV infections and monitor the circulation of EV types, we have established European non-polio enterovirus network (ENPEN). First task of this cross-border network has been to ensure prompt and adequate diagnosis of these infections in Europe, and hence we present recommendations for non-polio EV detection and typing based on the consensus view of this multidisciplinary team including experts from over 20 European countries. We recommend that respiratory and stool samples in addition to cerebrospinal fluid (CSF) and blood samples are submitted for EV testing from patients with suspected neurological infections. This is vital since viruses like EV-D68 are rarely detectable in CSF or stool samples. Furthermore, reverse transcriptase PCR (RT-PCR) targeting the 5′noncoding regions (5′NCR) should be used for diagnosis of EVs due to their sensitivity, specificity and short turnaround time. Sequencing of the VP1 capsid protein gene is recommended for EV typing; EV typing cannot be based on the 5′NCR sequences due to frequent recombination events and should not rely on virus isolation. Effective and standardized laboratory diagnostics and characterisation of circulating virus strains are the first step towards effective and continuous surveillance activities, which in turn will be used to provide better estimation on EV disease burden.

Original languageEnglish
Pages (from-to)11-17
Number of pages7
JournalJournal of Clinical Virology
Volume101
DOIs
Publication statusPublished - Apr 1 2018

Fingerprint

Enterovirus
Viruses
Cerebrospinal Fluid
Infection
Enterovirus Infections
Capsid Proteins
Reverse Transcriptase Polymerase Chain Reaction
Respiratory Tract Infections
Genetic Recombination
Disease Outbreaks

Keywords

  • Detection
  • Diagnostics
  • Enterovirus
  • European non-polio enterovirus network (ENPEN)
  • EV typing
  • Neurological infection

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

Harvala, H., Broberg, E., Benschop, K., Berginc, N., Ladhani, S., Susi, P., ... Fischer, T. K. (2018). Recommendations for enterovirus diagnostics and characterisation within and beyond Europe. Journal of Clinical Virology, 101, 11-17. https://doi.org/10.1016/j.jcv.2018.01.008

Recommendations for enterovirus diagnostics and characterisation within and beyond Europe. / Harvala, Heli; Broberg, Eeva; Benschop, Kimberley; Berginc, Natasa; Ladhani, Shamez; Susi, Petri; Christiansen, Claus; McKenna, James; Allen, David; Makiello, Phoebe; McAllister, Georgina; Carmen, Mirabelli; Zakikhany, Katherina; Dyrdak, Robert; Nielsen, Xiaohui; Madsen, Tina; Paul, Joel; Moore, Catherine; von Eije, Karin; Piralla, Antonio; Carlier, Mieke; Vanoverschelde, Laura; Poelman, Randy; Anton, Andrés; López-Labrador, F. Xavier; Pellegrinelli, Laura; Keeren, Kathrin; Maier, Melanie; Cassidy, Hayley; Derdas, Stavros; Savolainen-Kopra, Carita; Diedrich, Sabine; Nordbø, Svein; Buesa, Javier; Bailly, Jean Luc; Baldanti, Fausto; MacAdam, Andrew; Mirand, Audrey; Dudman, Susanne; Schuffenecker, Isabelle; Kadambari, Seilesh; Neyts, Johan; Griffiths, Michael J.; Richter, Jan; Margaretto, Cristina; Govind, Sheila; Morley, Ursula; Adams, Ortwin; Krokstad, Sidsel; Dean, Jonathan; Pons-Salort, Margarita; Prochazka, Birgit; Cabrerizo, Maria; Majumdar, Manasi; Nebbia, Gaia; Wiewel, Maryse; Cottrell, Simon; Coyle, Peter; Martin, Javier; Moore, Catrin; Midgley, Sofie; Horby, Peter; Wolthers, Katja; Simmonds, Peter; Niesters, Hubert; Fischer, Thea K.

In: Journal of Clinical Virology, Vol. 101, 01.04.2018, p. 11-17.

Research output: Contribution to journalReview article

Harvala, H, Broberg, E, Benschop, K, Berginc, N, Ladhani, S, Susi, P, Christiansen, C, McKenna, J, Allen, D, Makiello, P, McAllister, G, Carmen, M, Zakikhany, K, Dyrdak, R, Nielsen, X, Madsen, T, Paul, J, Moore, C, von Eije, K, Piralla, A, Carlier, M, Vanoverschelde, L, Poelman, R, Anton, A, López-Labrador, FX, Pellegrinelli, L, Keeren, K, Maier, M, Cassidy, H, Derdas, S, Savolainen-Kopra, C, Diedrich, S, Nordbø, S, Buesa, J, Bailly, JL, Baldanti, F, MacAdam, A, Mirand, A, Dudman, S, Schuffenecker, I, Kadambari, S, Neyts, J, Griffiths, MJ, Richter, J, Margaretto, C, Govind, S, Morley, U, Adams, O, Krokstad, S, Dean, J, Pons-Salort, M, Prochazka, B, Cabrerizo, M, Majumdar, M, Nebbia, G, Wiewel, M, Cottrell, S, Coyle, P, Martin, J, Moore, C, Midgley, S, Horby, P, Wolthers, K, Simmonds, P, Niesters, H & Fischer, TK 2018, 'Recommendations for enterovirus diagnostics and characterisation within and beyond Europe' Journal of Clinical Virology, vol. 101, pp. 11-17. https://doi.org/10.1016/j.jcv.2018.01.008
Harvala, Heli ; Broberg, Eeva ; Benschop, Kimberley ; Berginc, Natasa ; Ladhani, Shamez ; Susi, Petri ; Christiansen, Claus ; McKenna, James ; Allen, David ; Makiello, Phoebe ; McAllister, Georgina ; Carmen, Mirabelli ; Zakikhany, Katherina ; Dyrdak, Robert ; Nielsen, Xiaohui ; Madsen, Tina ; Paul, Joel ; Moore, Catherine ; von Eije, Karin ; Piralla, Antonio ; Carlier, Mieke ; Vanoverschelde, Laura ; Poelman, Randy ; Anton, Andrés ; López-Labrador, F. Xavier ; Pellegrinelli, Laura ; Keeren, Kathrin ; Maier, Melanie ; Cassidy, Hayley ; Derdas, Stavros ; Savolainen-Kopra, Carita ; Diedrich, Sabine ; Nordbø, Svein ; Buesa, Javier ; Bailly, Jean Luc ; Baldanti, Fausto ; MacAdam, Andrew ; Mirand, Audrey ; Dudman, Susanne ; Schuffenecker, Isabelle ; Kadambari, Seilesh ; Neyts, Johan ; Griffiths, Michael J. ; Richter, Jan ; Margaretto, Cristina ; Govind, Sheila ; Morley, Ursula ; Adams, Ortwin ; Krokstad, Sidsel ; Dean, Jonathan ; Pons-Salort, Margarita ; Prochazka, Birgit ; Cabrerizo, Maria ; Majumdar, Manasi ; Nebbia, Gaia ; Wiewel, Maryse ; Cottrell, Simon ; Coyle, Peter ; Martin, Javier ; Moore, Catrin ; Midgley, Sofie ; Horby, Peter ; Wolthers, Katja ; Simmonds, Peter ; Niesters, Hubert ; Fischer, Thea K. / Recommendations for enterovirus diagnostics and characterisation within and beyond Europe. In: Journal of Clinical Virology. 2018 ; Vol. 101. pp. 11-17.
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AU - Harvala, Heli

AU - Broberg, Eeva

AU - Benschop, Kimberley

AU - Berginc, Natasa

AU - Ladhani, Shamez

AU - Susi, Petri

AU - Christiansen, Claus

AU - McKenna, James

AU - Allen, David

AU - Makiello, Phoebe

AU - McAllister, Georgina

AU - Carmen, Mirabelli

AU - Zakikhany, Katherina

AU - Dyrdak, Robert

AU - Nielsen, Xiaohui

AU - Madsen, Tina

AU - Paul, Joel

AU - Moore, Catherine

AU - von Eije, Karin

AU - Piralla, Antonio

AU - Carlier, Mieke

AU - Vanoverschelde, Laura

AU - Poelman, Randy

AU - Anton, Andrés

AU - López-Labrador, F. Xavier

AU - Pellegrinelli, Laura

AU - Keeren, Kathrin

AU - Maier, Melanie

AU - Cassidy, Hayley

AU - Derdas, Stavros

AU - Savolainen-Kopra, Carita

AU - Diedrich, Sabine

AU - Nordbø, Svein

AU - Buesa, Javier

AU - Bailly, Jean Luc

AU - Baldanti, Fausto

AU - MacAdam, Andrew

AU - Mirand, Audrey

AU - Dudman, Susanne

AU - Schuffenecker, Isabelle

AU - Kadambari, Seilesh

AU - Neyts, Johan

AU - Griffiths, Michael J.

AU - Richter, Jan

AU - Margaretto, Cristina

AU - Govind, Sheila

AU - Morley, Ursula

AU - Adams, Ortwin

AU - Krokstad, Sidsel

AU - Dean, Jonathan

AU - Pons-Salort, Margarita

AU - Prochazka, Birgit

AU - Cabrerizo, Maria

AU - Majumdar, Manasi

AU - Nebbia, Gaia

AU - Wiewel, Maryse

AU - Cottrell, Simon

AU - Coyle, Peter

AU - Martin, Javier

AU - Moore, Catrin

AU - Midgley, Sofie

AU - Horby, Peter

AU - Wolthers, Katja

AU - Simmonds, Peter

AU - Niesters, Hubert

AU - Fischer, Thea K.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Enteroviruses (EV) can cause severe neurological and respiratory infections, and occasionally lead to devastating outbreaks as previously demonstrated with EV-A71 and EV-D68 in Europe. However, these infections are still often underdiagnosed and EV typing data is not currently collected at European level. In order to improve EV diagnostics, collate data on severe EV infections and monitor the circulation of EV types, we have established European non-polio enterovirus network (ENPEN). First task of this cross-border network has been to ensure prompt and adequate diagnosis of these infections in Europe, and hence we present recommendations for non-polio EV detection and typing based on the consensus view of this multidisciplinary team including experts from over 20 European countries. We recommend that respiratory and stool samples in addition to cerebrospinal fluid (CSF) and blood samples are submitted for EV testing from patients with suspected neurological infections. This is vital since viruses like EV-D68 are rarely detectable in CSF or stool samples. Furthermore, reverse transcriptase PCR (RT-PCR) targeting the 5′noncoding regions (5′NCR) should be used for diagnosis of EVs due to their sensitivity, specificity and short turnaround time. Sequencing of the VP1 capsid protein gene is recommended for EV typing; EV typing cannot be based on the 5′NCR sequences due to frequent recombination events and should not rely on virus isolation. Effective and standardized laboratory diagnostics and characterisation of circulating virus strains are the first step towards effective and continuous surveillance activities, which in turn will be used to provide better estimation on EV disease burden.

AB - Enteroviruses (EV) can cause severe neurological and respiratory infections, and occasionally lead to devastating outbreaks as previously demonstrated with EV-A71 and EV-D68 in Europe. However, these infections are still often underdiagnosed and EV typing data is not currently collected at European level. In order to improve EV diagnostics, collate data on severe EV infections and monitor the circulation of EV types, we have established European non-polio enterovirus network (ENPEN). First task of this cross-border network has been to ensure prompt and adequate diagnosis of these infections in Europe, and hence we present recommendations for non-polio EV detection and typing based on the consensus view of this multidisciplinary team including experts from over 20 European countries. We recommend that respiratory and stool samples in addition to cerebrospinal fluid (CSF) and blood samples are submitted for EV testing from patients with suspected neurological infections. This is vital since viruses like EV-D68 are rarely detectable in CSF or stool samples. Furthermore, reverse transcriptase PCR (RT-PCR) targeting the 5′noncoding regions (5′NCR) should be used for diagnosis of EVs due to their sensitivity, specificity and short turnaround time. Sequencing of the VP1 capsid protein gene is recommended for EV typing; EV typing cannot be based on the 5′NCR sequences due to frequent recombination events and should not rely on virus isolation. Effective and standardized laboratory diagnostics and characterisation of circulating virus strains are the first step towards effective and continuous surveillance activities, which in turn will be used to provide better estimation on EV disease burden.

KW - Detection

KW - Diagnostics

KW - Enterovirus

KW - European non-polio enterovirus network (ENPEN)

KW - EV typing

KW - Neurological infection

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