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. 2025 May 5;17(5):673.
doi: 10.3390/v17050673.

Return of the Biennial Circulation of Enterovirus D68 in Colorado Children in 2024 Following the Large 2022 Outbreak

Hai Nguyen-Tran  1   2 , Molly Butler  2 , Dennis Simmons  2 , Samuel R Dominguez  1   2 , Kevin Messacar  1   2
Affiliations

Return of the Biennial Circulation of Enterovirus D68 in Colorado Children in 2024 Following the Large 2022 Outbreak

Hai Nguyen-Tran et al. Viruses. .

Abstract

Enterovirus D68 (EV-D68) caused large biennial cyclical outbreaks of respiratory disease and cases of acute flaccid myelitis from 2014 to 2018 in the USA. An anticipated outbreak did not occur in 2020, likely due to non-pharmaceutical interventions targeting the COVID-19 pandemic. A large respiratory disease outbreak occurred again in 2022, but uncertainty remained regarding if circulation of EV-D68 would return to the pre-pandemic patterns. We conducted prospective active surveillance of clinical respiratory specimens from Colorado children for EV-D68 in 2023 and 2024. A subset of residual specimens positive for rhinovirus/enterovirus (RV/EV) were tested for EV-D68 via a validated in-house EV-D68 reverse transcription-PCR assay. During epi weeks 18-44 in 2023, 525 residual specimens positive for RV/EV all tested negative for EV-D68. In 2024, during epi weeks 18-44, 10 (1.8%) of the 546 RV/EV-positive specimens were EV-D68-positive. The EV-D68-positive cases were predominantly young children (median age 4.8 years) receiving treatment with asthma medications. Following the 2022 EV-D68 outbreak, an anticipated outbreak did not occur in 2023. While EV-D68 was detected in 2024, the number of cases was not as significant as in prior outbreak years. Continued surveillance for EV-D68 will be important to understand the future dynamics of EV-D68 circulation and prepare for future outbreaks.

Keywords: enterovirus D68; respiratory disease; surveillance.

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Conflict of interest statement

H.N.-T. received an honorarium/travel support from bioMerieux for conference speaking. S.R.D. serves as a consultant for BioFire Diagnostics. All the other authors have no conflicts of interests to disclose.

Figures

Figure 1
Figure 1
Enterovirus D68 (EV-D68)- and rhinovirus/enterovirus (RV/EV)-positive cases in children in Colorado by epi week in 2023 and 2024.
See this image and copyright information in PMC

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