Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Feb 8;16(2):e0010073.
doi: 10.1371/journal.pntd.0010073. eCollection 2022 Feb.

Global prevalence and case fatality rate of Enterovirus D68 infections, a systematic review and meta-analysis

Amary Fall  1 , Sebastien Kenmoe  2   3 , Jean Thierry Ebogo-Belobo  4 , Donatien Serge Mbaga  5 , Arnol Bowo-Ngandji  5 , Joseph Rodrigue Foe-Essomba  6 , Serges Tchatchouang  7 , Marie Amougou Atsama  8 , Jacqueline Félicité Yéngué  9 , Raoul Kenfack-Momo  10 , Alfloditte Flore Feudjio  10 , Alex Durand Nka  11 , Chris Andre Mbongue Mikangue  5 , Jean Bosco Taya-Fokou  5 , Jeannette Nina Magoudjou-Pekam  10 , Efietngab Atembeh Noura  4 , Cromwel Zemnou-Tepap  10 , Dowbiss Meta-Djomsi  8 , Martin Maïdadi-Foudi  8 , Ginette Irma Kame-Ngasse  4 , Inès Nyebe  5 , Larissa Gertrude Djukouo  10 , Landry Kengne Gounmadje  10 , Dimitri Tchami Ngongang  5 , Martin Gael Oyono  9 , Cynthia Paola Demeni Emoh  5 , Hervé Raoul Tazokong  5 , Gadji Mahamat  5 , Cyprien Kengne-Ndé  12 , Serge Alain Sadeuh-Mba  2 , Ndongo Dia  1 , Giuseppina La Rosa  13 , Lucy Ndip  3 , Richard Njouom  2
Affiliations
Meta-Analysis

Global prevalence and case fatality rate of Enterovirus D68 infections, a systematic review and meta-analysis

Amary Fall et al. PLoS Negl Trop Dis. .

Abstract

A substantial amount of epidemiological data has been reported on Enterovirus D68 (EV-D68) infections after the 2014 outbreak. Our goal was to map the case fatality rate (CFR) and prevalence of current and past EV-D68 infections. We conducted a systematic review (PROSPERO, CRD42021229255) with published articles on EV-68 infections in PubMed, Embase, Web of Science and Global Index Medicus up to January 2021. We determined prevalences using a model random effect. Of the 4,329 articles retrieved from the databases, 89 studies that met the inclusion criteria were from 39 different countries with apparently healthy individuals and patients with acute respiratory infections, acute flaccid myelitis and asthma-related diseases. The CFR estimate revealed occasional deaths (7/1353) related to EV-D68 infections in patients with severe acute respiratory infections. Analyses showed that the combined prevalence of current and past EV-D68 infections was 4% (95% CI = 3.1-5.0) and 66.3% (95% CI = 40.0-88.2), respectively. The highest prevalences were in hospital outbreaks, developed countries, children under 5, after 2014, and in patients with acute flaccid myelitis and asthma-related diseases. The present study shows sporadic deaths linked to severe respiratory EV-D68 infections. The study also highlights a low prevalence of current EV-D68 infections as opposed to the existence of EV-D68 antibodies in almost all participants of the included studies. These findings therefore highlight the need to implement and/or strengthen continuous surveillance of EV-D68 infections in hospitals and in the community for the anticipation of the response to future epidemics.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram summarizing the selection of eligible studies.
Fig 2
Fig 2. Global distribution, case fatality rate, and prevalence estimate of Enterovirus D68 current and past infections.
The figures represent from top to bottom: the Enterovirus D68 case fatality rate and the prevalence of Enterovirus D68 current and past infections. Map source: https://www.datawrapper.de/basemaps/world/.
Fig 3
Fig 3. The pooled global case fatality rate of Enterovirus D68.
Fig 4
Fig 4. The pooled global prevalence of Enterovirus D68 current infections.
Fig 5
Fig 5. The pooled global prevalence of Enterovirus D68 past infections.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Smura T, Ylipaasto P, Klemola P, Kaijalainen S, Kyllonen L, Sordi V, et al. Cellular tropism of human enterovirus D species serotypes EV-94, EV-70, and EV-68 in vitro: implications for pathogenesis. J Med Virol. 2010;82(11):1940–9. Epub 2010/09/28. doi: 10.1002/jmv.21894 . - DOI - PubMed
    1. Solomon T, Lewthwaite P, Perera D, Cardosa MJ, McMinn P, Ooi MH. Virology, epidemiology, pathogenesis, and control of enterovirus 71. Lancet Infect Dis. 2010;10(11):778–90. Epub 2010/10/22. doi: 10.1016/S1473-3099(10)70194-8 . - DOI - PubMed
    1. Tapparel C, Junier T, Gerlach D, Van-Belle S, Turin L, Cordey S, et al. New respiratory enterovirus and recombinant rhinoviruses among circulating picornaviruses. Emerg Infect Dis. 2009;15(5):719–26. Epub 2009/05/01. doi: 10.3201/eid1505.081286 - DOI - PMC - PubMed
    1. Pons-Salort M, Parker EP, Grassly NC. The epidemiology of non-polio enteroviruses: recent advances and outstanding questions. Curr Opin Infect Dis. 2015;28(5):479–87. Epub 2015/07/24. doi: 10.1097/QCO.0000000000000187 - DOI - PMC - PubMed
    1. Schieble JH, Kase A, Lennette EH. Fluorescent cell counting as an assay method for respiratory syncytial virus. J Virol. 1967;1(3):494–9. Epub 1967/06/01. doi: 10.1128/JVI.1.3.494-499.1967 - DOI - PMC - PubMed

Publication types

Substances

Supplementary concepts