Enterovirus infections in England and Wales, 2000-2011: The impact of increased molecular diagnostics

S. Kadambari, A. Bukasa, I. O. Okike, Richard Pebody, David Brown, Christopher Gallimore, J. Xerry, M. Sharland, Shamez Ladhani

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

Abstract

There have recently been significant changes in diagnostic practices for detecting enterovirus (EV) infections across England and Wales. Reports of laboratory-confirmed EV infections submitted by National Health Service (NHS) hospital laboratories to Public Health England (PHE) over a 12-year period (2000-2011) were analysed. Additionally, the PHE Virus Reference Department (VRD) electronic database containing molecular typing data from 2004 onwards was interrogated. Of the 13 901 reports, there was a decline from a peak of 2254 in 2001 to 589 in 2006, and then an increase year-on-year to 1634 in 2011. This increase coincided with increasing PCR-based laboratory diagnosis, which accounted for 36% of reported cases in 2000 and 92% in 2011. The estimated annual incidence in 2011 was 3.9/100 000 overall and 238/100 000 in those aged <3 months, who accounted for almost one-quarter of reported cases (n = 2993, 23%). During 2004-2011, 2770 strains were submitted for molecular typing to the VRD, who found no evidence for a predominance of any particular strain. Thus, the recent increase in reported cases closely reflects the increase in PCR testing by NHS hospitals, but is associated with a lower proportion of samples being submitted for molecular typing. The high EV rate in young infants merits further investigation to inform evidence-based management guidance.

Original languageEnglish
Pages (from-to)1289-1296
Number of pages8
JournalClinical Microbiology and Infection
Volume20
Issue number12
DOIs
Publication statusPublished - 1 Dec 2014

Keywords

  • Cell culture
  • Enterovirus
  • Genotyping
  • PCR
  • Surveillance

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