Abstract

Background. Non-polio enteroviruses (EVs) and human parechoviruses (PeVs) cause a wide range of human infections. Limited data on their true disease burden exist as standardized European-wide surveillance is lacking. Aims. Our aim is to estimate the disease burden of EV and PeV infections in Europe via establishment of standardized surveillance for hand, foot and mouth disease (HFMD) and respiratory and neurological infections caused by these viruses. We will also assess the sensitivity of assays implemented in the network of participating laboratories so that all EV and PeV types are adequately detected. Plan. The European Non-Polio Enterovirus Network (ENPEN) has developed standardized protocols for a prospective, multi-center and cross-sectional hospital-based pilot study. Protocols include guidance for diagnosis, case definition, detection, characterization and reporting of EV and PeV infections associated with HFMD and respiratory and neurological diseases. Over 30 sites from 17 European countries have already registered to this one pilot study, likely to be commenced in 2022. Benefits. This surveillance will allow European-wide comparison of data on EV and PeV infection. These data will also be used to determine the burden of EV and PeV infections, which is needed to guide the further prevention measures and policies.

Highlights

  • Non-polio enteroviruses (EVs) and human parechoviruses (PeVs) cause a wide range of human infections

  • This is an innovative and challenging task because many European countries have not set up hospital-based surveillance networks previously, and the existing approaches vary between countries

  • The first draft for each study protocol was drafted in the European Non-Polio Enterovirus Network (ENPEN) establishment meeting in Oxford, UK (10–12 May 2018); these were subsequently circulated to possible members from candidate hospitals, and further communications in order to finalize these protocols between the participating network members were conducted via emails and teleconferences

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Summary

Background

Non-polio enteroviruses (EVs) and parechoviruses (PeVs) are known as the main causes of meningitis affecting children and young adults [1,2]. To address this lack of standardization and coordination of investigations across national boundaries, the European Non-Polio Enterovirus Network (ENPEN) has been recently established This network of clinical and molecular virologists, clinicians (paediatricians, neurologists and infectious diseases physicians), epidemiologists and public health experts functions in collaboration to develop and share knowledge on diagnostic techniques for EV and PeV detection and characterization, disease presentations and prognosis, virus evolution and pathogenesis [24]. In addition to coordinating collaborative projects and fostering a better awareness of EV- and PeV-related diseases, its overarching aim is to provide data on the burden of these infections in Europe through the establishment of a European-wide surveillance platform for EVs and PeVs which are described in this paper This is an innovative and challenging task because many European countries have not set up hospital-based surveillance networks previously, and the existing approaches vary between countries. Experience from countries where multidisciplinary teams including clinical virologists, paediatricians and public health experts are already working effectively and closely together will be shared to demonstrate how team working can be established and how it can help to achieve set aims

Main Aims
Development of Hospital-Based Surveillance
Study Protocols for Hospital-Based Surveillance
Specific Aspects of the Respiratory Protocol
Specific Aspects of the Neurological Study
Specific Aspects of the HFMD Protocol
Ethical Considerations and Data Collection Tools
Commentary
Conclusions
Findings
Xavier Lopez Labrador
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