Real-Time Enterovirus D68 Outbreak Detection through Hospital Surveillance of Severe Acute Respiratory Infection, Senegal, 2023

Abstract

In December 2023, we observed through hospital-based surveillance a severe outbreak of enterovirus D68 infection in pediatric inpatients in Dakar, Senegal. Molecular characterization revealed that subclade B3, the dominant lineage in outbreaks worldwide, was responsible for the outbreak. Enhanced surveillance in inpatient settings, including among patients with neurologic illnesses, is needed.

Keywords: Dakar; EV-D68 viruses; SARI; Senegal; enterovirus D68; severe acute respiratory infection; surveillance; viruses.

Figure 1

Referral hospitals contributing to the hospital-based surveillance of severe acute respiratory infection (red circles), Dakar, Senegal, 2023. Inset map show study area in Senegal.

Figure 2

Weekly distribution of EV-D68 in patients with acute respiratory infection, Dakar Senegal, 2023. Bars represent the number of samples tested for each epidemiologic week. Line indicates number samples positive for EV-D68. Scales for the y-axes differ substantially to underscore patterns but do not permit direct comparisons. EV-D68, enterovirus D68; ILI, influenza-like illness; SARI, severe acute respiratory illness.

Figure 3

Maximum-likelihood phylogenetic tree based on the nucleotide sequences of major capsid protein gene region of enterovirus D68 from Senegal (red text) and reference sequences. Tree was constructed by using IQ-TREE2 2.0.6 (http://www.iqtree.org) and visualized by using Figtree 1.4.4 (http://tree.bio.ed.ac.uk/software/figtree). Statistical significance was tested by using 1,000 bootstrapping replicates. Software was used to define the correct model used. Tree is rooted by the Fermon strain. Scale bar indicates substitutions per site.