European Non-Polio Enterovirus Network: Introduction of Hospital-Based Surveillance Network to Understand the True Disease Burden of Non-Polio Enterovirus and Parechovirus Infections in Europe
Abstract
:1. Background
2. Main Aims
3. Surveillance Protocols
3.1. Development of Hospital-Based Surveillance
3.2. Study Protocols for Hospital-Based Surveillance
3.3. Specific Aspects of the Respiratory Protocol
3.4. Specific Aspects of the Neurological Study
3.5. Specific Aspects of the HFMD Protocol
3.6. Ethical Considerations and Data Collection Tools
4. Commentary
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Name | Institute |
Catherine Moore | Public Health Wales Microbiology, University Hospital of Wales, Cardiff, UK |
Lubomira Nikolaeva-Glomb | National Center of Infectious and Parasitic Diseases, National Reference Laboratory of Enteroviruses, Sofia, Bulgaria |
Lili Pekova | Department of Hygiene, Epidemiology, Microbiology, Parasitology and Infectious Diseases, Trakia University, Stara Zagora, Bulgaria |
Maria Pishmisheva | Multiprofile Hospital for Active Treatment Pazardjik, Bulgaria |
F. Xavier Lopez Labrador | Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Spain |
Javier Díez Domingo | Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Spain |
Maria Carberizo | Reference Laboratory for Immunopreventable Viral Diseases, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain |
Cristina Calvo | Hospital Universitario La Paz (Madrid), Spain |
Maria Itziar Pocheville Gureceta | Hospital Universitario Cruces (Bilbao), Spain |
Maitane Aranzamendi Zaldumbide | Servicio de Microbiologia, Hospital Universitario Cruces (Bilbao), Spain |
Juan Valencia-Ramo | Hospital Universitario de Burgos (Burgos), Spain |
Nuria Rabella | Hospital Universitario de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain |
Irena Tabain | Croatian National Institute of Public Health, Croatia |
Blaženka Hunjak | Croatian National Institute of Public Health, Croatia |
Goran Tesovic | Clinic of Infectious Diseases, Dr. Fran Mihaljevic (CID), Croatia |
Elena Pariani | Department of Biomedical sciences for Health, University of Milan, Milan, Lombardy, Italy |
Cristina Galli | Department of Biomedical sciences for Health, University of Milan, Milan, Lombardy, Italy |
Sandro Binda | Department of Biomedical sciences for Health, University of Milan, Milan, Lombardy, Italy |
Laura Pellegrinelli | Department of Biomedical sciences for Health, University of Milan, Milan, Lombardy, Italy |
Antonio piralla | Fondazione IRCCS Policlinico San Matteo, Microbiology and Virology Department, Molecular Virology Unit, Pavia, Lombardy, Italy |
Federica Giardina | Fondazione IRCCS Policlinico San Matteo, Molecular Virology Unit, Pavia, Lombardy, Italy |
Andres Anton | Hospital Universitario Vall d’Hebron, Barcelona Hospital Campus, Catalonia, Spain |
Jorgina Vila | Hospital Universitario Vall d’Hebron, Barcelona Hospital Campus, Catalonia, Spain |
Robert Dyrdak | Dept of Microbiology, Karolinska Institute and Dept of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden |
Jan Albert | Dept of Microbiology, Karolinska Institute; Dept of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden |
Xiaohui Chen Nielsen | The regional department of Clinical Microbiology, Zealand University Hospital, Slagelse, Denmark |
Miroslav Petrovec | University of Ljubljana, Medical Faculty, Institute for microbiology and immunology, Slovenia |
Mario Poljak | University of Ljubljana, Medical Faculty, Institute for microbiology and immunology, Slovenia |
Lieuwe Roorda | Maasstad Ziekenhuis, Rotterdam, the Netherlands |
Jaco J Verweij | ElisabethTweesteden Hospital, Tilburg, the Netherlands |
Jean-Luc Murk | ElisabethTweesteden Hospital, Tilburg, the Netherlands |
Mario Hönemann | Institute for virology, University Hospital of Leipzig, German |
Melanie Maier | Institute for virology, University Hospital of Leipzig, German |
Svein Arne Nordbo | St Olav Hospital, Trondheim, Norway |
Susanne Dudman | Institute of clinical medicine, University of Oslo, and Oslo University Hospital, Medical Faculty, Oslo, Norway |
Berg, Are Stuwitz | NIPH Norway |
Silvia Bino | Institute of Public Health, Tirana, Albania |
Petra Rainetova | National Institute of Public Health, NRL for Enteroviruses, Czech Republic |
Ondrej Cinek | National Institute of Public Health, Czech Republic, NRL for Enteroviruses, Czech Republic |
Labská Klára | National Institute of Public Health, Czech Republic, NRL for Enteroviruses, Czech Republic |
Elke Wollants | KU Leuven, Clinical and Epidemiological Virology, Belgium |
Raquel Guiomar | National Institute of Health, Lisbon, Portugal (INSA), Portugal |
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Neurological Infections | Respiratory Infections | HFMD | |
---|---|---|---|
Case definition | Any individual older than 1 year of age: suspected neurological infection with an EV or PeV RNA detected in samples within 3 weeks of symptom onset. Any individual below 1 year of age: suspected neurological infection or sepsis-like illness with an EV or PeV RNA detected in samples within 3 weeks of symptom onset. | Any individual with a respiratory disease considered to have an infectious cause AND a laboratory-confirmed EV or PeV infection. | Any child under 16 years of age presenting with HFMD and EV or PeV RNA has been detected in a clinical specimen. |
Clinical samples | CSF and stool/rectal swab, preferably also a respiratory tract sample or alternative respiratory tract specimen. In case of AFP/AFM, a respiratory specimen is obligatory to allow EV-68 detection. | A respiratory sample such as a nasopharyngeal swab or aspirate, a throat swab, a combined nose and throat swab, sputum or bronchoalveolar lavage (BAL). | Vesicle, throat or buccal swab or skin biopsy. |
Study population | All individuals. | ||
Study period | 1 year—starting date has not been defined yet due to COVID-19 pandemic (it was initially 1 May 2020). | ||
Inclusion criteria | Any case meeting the case definition, attending or admitted to hospital who has given informed consent and for whom a clinical sample was tested for EV and/or PeV. | ||
Exclusion criteria | Individuals fulfilling the case definition but testing negative for EV and PeV will be excluded but recorded in the study as a denominator. | Individuals with other respiratory virus infections such as influenza or RSV will be excluded but recorded in the study as a denominator. | Non-hospitalized individuals aged over 16 years will be excluded from this study. |
Data collection | Study site information includes denominator data for population size covered by study site, number of patients overall and with neurological infections by study site and over study period. Laboratory information includes data on methodology used. Patient information including demographics, clinical and virological information. All data will be collected on standardized forms and in anonymized format. | Data collection consists of 3 parts: (1) participation form will be collected at the start of the study, (2) clinical research form will be collected after the initial investigations, and 3 and 6 months after diagnosis and (3) aggregated data on number of individuals attending hospital and tested for EV. All data will be collected on standardized forms and in anonymized format. | Clinical and virological data will be completed by the clinicians and the microbiologist for all children presenting with HFMD and attending a participating pediatric hospital who are tested for EV or PeV RNA. Further denominator data include the population size covered by study site. All data will be collected in an anonymized format, and only aggregated data will be shared between countries. |
Analysis plan | Data will be processed, analyzed and monitored every month, within 1 week of last submission deadline. Data will be reported 3-monthly, and a more detailed annual report will also be provided to all contributors. | ||
Countries with intention to participate | Albania, Belgium, Bulgaria, Czech Republic, Croatia, Denmark, France, Italy, Norway, Slovenia, Spain, Sweden, the Netherlands and the UK including Wales. | Albania, Bulgaria, Denmark, France, Germany, Italy, Portugal, Slovenia, Spain, Sweden, the Netherlands and the UK including Wales. | Bulgaria, Czech Republic, Denmark, the Netherlands, Spain, Sweden and the UK including Wales. |
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Harvala, H.; Benschop, K.S.M.; Berginc, N.; Midgley, S.; Wolthers, K.; Simmonds, P.; Feeney, S.; Bailly, J.-L.; Mirand, A.; Fischer, T.K.; et al. European Non-Polio Enterovirus Network: Introduction of Hospital-Based Surveillance Network to Understand the True Disease Burden of Non-Polio Enterovirus and Parechovirus Infections in Europe. Microorganisms 2021, 9, 1827. https://doi.org/10.3390/microorganisms9091827
Harvala H, Benschop KSM, Berginc N, Midgley S, Wolthers K, Simmonds P, Feeney S, Bailly J-L, Mirand A, Fischer TK, et al. European Non-Polio Enterovirus Network: Introduction of Hospital-Based Surveillance Network to Understand the True Disease Burden of Non-Polio Enterovirus and Parechovirus Infections in Europe. Microorganisms. 2021; 9(9):1827. https://doi.org/10.3390/microorganisms9091827
Chicago/Turabian StyleHarvala, Heli, Kimberley S. M. Benschop, Natasa Berginc, Sofie Midgley, Katja Wolthers, Peter Simmonds, Susan Feeney, Jean-Luc Bailly, Audrey Mirand, Thea K. Fischer, and et al. 2021. "European Non-Polio Enterovirus Network: Introduction of Hospital-Based Surveillance Network to Understand the True Disease Burden of Non-Polio Enterovirus and Parechovirus Infections in Europe" Microorganisms 9, no. 9: 1827. https://doi.org/10.3390/microorganisms9091827
APA StyleHarvala, H., Benschop, K. S. M., Berginc, N., Midgley, S., Wolthers, K., Simmonds, P., Feeney, S., Bailly, J.-L., Mirand, A., Fischer, T. K., & on behalf of the ENPEN Hospital-Based Surveillance Network. (2021). European Non-Polio Enterovirus Network: Introduction of Hospital-Based Surveillance Network to Understand the True Disease Burden of Non-Polio Enterovirus and Parechovirus Infections in Europe. Microorganisms, 9(9), 1827. https://doi.org/10.3390/microorganisms9091827