During 2014, enterovirus D68 (EV-D68) outbreaks were described globally, causing severe respiratory diseases in children and, in some cases, subsequent paralysis. In this study, the type characterization of enterovirus (EV) detected in respiratory illnesses and the epidemiology and clinical association of EV-D68 infections in Spain over a five-year period were described. A total of 546 EV-positive samples from hospitalized patients with respiratory infections were included. EV-D68 was the most frequently detected type (46.6%, 191/410 typed EV). Other EV from species A (25.1%), B (27.8%) and C (0.5%) were also identified. EV-D68 infections were more associated with bronchitis while EV-A/B types were more frequent in upper respiratory illness (p < 0.01). EV-D68 was also detected in patients with neurological symptoms (nine meningitis/meningoencephalitis and eight acute flaccid paralysis cases). Phylogenetic analysis of 3'-VP1 region showed most Spanish EV-D68 sequences from 2014 to 2016 belonged to subclades B2/B3, as other American and European strains circulating during the same period. However, those detected in 2017 and 2018 clustered to the emerged subclade D1. In summary, different EV can cause respiratory infections but EV-D68 was the most prevalent, with several strains circulating in Spain at least since 2014. Association between EV-D68 infection and neurological disease was also described.

中文翻译：

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2014-2018年西班牙肠道病毒D68相关的呼吸道和神经系统疾病。

2014年期间，全球描述了肠道病毒D68（EV-D68）的爆发，导致儿童严重的呼吸系统疾病，在某些情况下还导致随后的瘫痪。在这项研究中，描述了在五年内在呼吸道疾病中检测到的肠道病毒（EV）的类型特征以及EV-D68感染的流行病学和临床关联。包括来自呼吸道感染住院患者的546份EV阳性样本。EV-D68是最常见的类型（46.6％，191/410型EV）。还确定了来自物种A（25.1％），B（27.8％）和C（0.5％）的其他EV。在上呼吸道疾病中，EV-D68感染与支气管炎相关性更高，而EV-A / B类型则更为常见（p <0.01）。在有神经系统症状的患者（9例脑膜炎/脑膜脑炎和8例急性弛缓性麻痹病例）中也检测到EV-D68。对3'-VP1区域进行的系统进化分析显示，2014年至2016年间，大多数西班牙EV-D68序列属于B2 / B3分支，这与同期传播的其他美洲和欧洲菌株相同。然而，2017年和2018年检测到的那些聚类到了出现的D1分支中。总而言之，不同的EV可以引起呼吸道感染，但EV-D68最为流行，至少自2014年以来西班牙就传播了几株。还描述了EV-D68感染与神经系统疾病之间的关联。就像同一时期传播的其他美洲和欧洲毒株一样。但是，2017年和2018年检测到的那些聚类到了出现的D1分支中。总而言之，不同的EV可以引起呼吸道感染，但EV-D68最为流行，至少自2014年以来西班牙就传播了几株。还描述了EV-D68感染与神经系统疾病之间的关联。就像同一时期传播的其他美洲和欧洲毒株一样。但是，2017年和2018年检测到的那些聚类到了出现的D1分支中。总而言之，不同的EV可以引起呼吸道感染，但EV-D68最为流行，至少自2014年以来西班牙就传播了几株。还描述了EV-D68感染与神经系统疾病之间的关联。