Enterovirus D68 in Europe, 2025: continent-wide predominance of subclade A2/D and shift from pediatric to adult cases
- 1Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden; Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Ins
Abstract
BackgroundEnterovirus D68 (EV-D68) has predominantly caused infections in children, and detected cases have mainly been infected by subclade B3. In 2025, however, a substantial number of infections in adults was noted.
AimTo detail the molecular epidemiology of the 2025 season in Europe.
MethodsCase and sequencing data was collected from members in the European Non-Polio Enterovirus Network (ENPEN). The participating sites included both clinical and public health laboratories.
ResultsData was collected from 13 countries at 23 sites. There were 187 clinical cases infected with EV-D68 and 127 detections in wastewater. Age data were available for 76% (143/187), among which 90 cases were adults. VP1-based genotyping showed subclade A2/D to predominate in all age groups and across all participating countries, as well as in the sewage sampling performed at one site. Two interclade recombinant sequences were detected among 22 whole genome sequences.
ConclusionThe observed shift towards adult cases and subclade A2/D predominance warrants continued monitoring to determine whether this represents a sustained epidemiological change. The detection of interclade recombinant variants highlights a need to supplement regular VP1-based genotyping with whole-genome sequencing.
Related
- Clinical outcomes during the 2025-2026 and 2024-2025 influenza seasons in a US EHR network: an ecological comparison during A(H3N2) subclade K predominance.
- A narrative review of the state of urinary diversion: ileal conduit, neobladder, continent cutaneous, and cutaneous ureterostomy
- Digital pathological classification of peripheral neuroblastic tumors across multi-continent cohorts
- Predominance of autoimmune heparin-induced thrombocytopenia in a nephrology department
- Generalized Dystonia With Cervical Predominance in a Patient With a De Novo TCF20 Variant
BibTeX
@misc{dyrdak2026enterovirus,
title = {{Enterovirus D68 in Europe, 2025: continent-wide predominance of subclade A2/D and shift from pediatric to adult cases}},
author = {R. Dyrdak and G. Naver and N. Neuner-Jehle and , A. Gonzalez Sanchez and Y. Adedeji and L. Andersson-Li and C. Andres and A. Anton and B. Armannsdottir and K. Arowolo and A. Arunagirinathan and G. E. Baldvinsdottir and N. Berginc and K. Bicknell and M. Bisseux and S. Broddesson and C. Castilletti and P. Congedo and P. Crossley and L. Cuypers and N. de Graaf and A. Eis-Hübinger and R. Feletti and L. Gomes and R. Guiomar and M. Jeannoel and G. McAllister and C. P. McClure and A. Meijer and S. Midgley and A. Mirand and R. Molenkamp and C. Munoz-Almagro and J.-L. Murk and D. Oggioni and M. Oggioni and E. Pariani and L. Pellegrinelli and A. Perez-Arguello and M. Petrovec and P},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.23.26366309},
url = {https://www.medrxiv.org/content/10.64898/2026.10.23.26366309v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Enterovirus D68 in Europe, 2025: continent-wide predominance of subclade A2/D and shift from pediatric to adult cases
AU - R. Dyrdak
AU - G. Naver
AU - N. Neuner-Jehle
AU - , A. Gonzalez Sanchez
AU - Y. Adedeji
AU - L. Andersson-Li
AU - C. Andres
AU - A. Anton
AU - B. Armannsdottir
AU - K. Arowolo
AU - A. Arunagirinathan
AU - G. E. Baldvinsdottir
AU - N. Berginc
AU - K. Bicknell
AU - M. Bisseux
AU - S. Broddesson
AU - C. Castilletti
AU - P. Congedo
AU - P. Crossley
AU - L. Cuypers
AU - N. de Graaf
AU - A. Eis-Hübinger
AU - R. Feletti
AU - L. Gomes
AU - R. Guiomar
AU - M. Jeannoel
AU - G. McAllister
AU - C. P. McClure
AU - A. Meijer
AU - S. Midgley
AU - A. Mirand
AU - R. Molenkamp
AU - C. Munoz-Almagro
AU - J.-L. Murk
AU - D. Oggioni
AU - M. Oggioni
AU - E. Pariani
AU - L. Pellegrinelli
AU - A. Perez-Arguello
AU - M. Petrovec
AU - P
PY - 2026
DA - 2026/10/23
PB - medRxiv
DO - 10.64898/2026.10.23.26366309
UR - https://www.medrxiv.org/content/10.64898/2026.10.23.26366309v1
AB - BackgroundEnterovirus D68 (EV-D68) has predominantly caused infections in children, and detected cases have mainly been infected by subclade B3. In 2025, however, a substantial number of infections in adults was noted. AimTo detail the molecular epidemiology of the 2025 season in Europe. MethodsCase and sequencing data was collected from members in the European Non-Polio Enterovirus Network (ENPEN). The participating sites included both clinical and public health laboratories. ResultsData was collected from 13 countries at 23 sites. There were 187 clinical cases infected with EV-D68 and 127 detections in wastewater. Age data were available for 76% (143/187), among which 90 cases were adults. VP1-based genotyping showed subclade A2/D to predominate in all age groups and across all participating countries, as well as in the sewage sampling performed at one site. Two interclade recombinant sequences were detected among 22 whole genome sequences. ConclusionThe observed shift towards adult cases and subclade A2/D predominance warrants continued monitoring to determine whether this represents a sustained epidemiological change. The detection of interclade recombinant variants highlights a need to supplement regular VP1-based genotyping with whole-genome sequencing.
ER -