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We report on the increased circulation of enterovirus A71 in Germany in 2019. Strains were mainly identified in hospitalised patients with suspected aseptic meningitis/encephalitis. Molecular analysis showed co-circulation of EV-A71 sub-genogroups C1 and C4, a signal for physicians and public health authorities to include/intensify EV diagnostic in patients showing signs of aseptic meningitis, encephalitis or acute flaccid paralysis/myelitis.


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  1. Hassel C, Mirand A, Lukashev A, TerletskaiaLadwig E, Farkas A, Schuffenecker I, et al. Transmission patterns of human enterovirus 71 to, from and among European countries, 2003 to 2013. Euro Surveill. 2015;20(34):30005.  https://doi.org/10.2807/1560-7917.ES.2015.20.34.30005  PMID: 26530407 
  2. Böttcher S, Obermeier PE, Neubauer K, Diedrich SLaboratory Network for Enterovirus Diagnostics. Recombinant Enterovirus A71 Subgenogroup C1 Strains, Germany, 2015. Emerg Infect Dis. 2016;22(10):1843-6.  https://doi.org/10.3201/eid2210.160357  PMID: 27439117 
  3. Karrasch M, Fischer E, Scholten M, Sauerbrei A, Henke A, Renz DM, et al. A severe pediatric infection with a novel enterovirus A71 strain, Thuringia, Germany. J Clin Virol. 2016;84:90-5.  https://doi.org/10.1016/j.jcv.2016.09.007  PMID: 27771495 
  4. Ngangas ST, Lukashev A, Jugie G, Ivanova O, Mansuy JM, Mengelle C, et al. Multirecombinant Enterovirus A71 Subgenogroup C1 Isolates Associated with Neurologic Disease, France, 2016-2017. Emerg Infect Dis. 2019;25(6):1204-8.  https://doi.org/10.3201/eid2506.181460  PMID: 31107209 
  5. Wieczorek M, Purzyńska M, Krzysztoszek A, Ciąćka A, Figas A, Szenborn L. Genetic characterization of enterovirus A71 isolates from severe neurological cases in Poland. J Med Virol. 2018;90(2):372-6.  https://doi.org/10.1002/jmv.24958  PMID: 28960454 
  6. Antona D, Kossorotoff M, Schuffenecker I, Mirand A, Leruez-Ville M, Bassi C, et al. Severe paediatric conditions linked with EV-A71 and EV-D68, France, May to October 2016. Euro Surveill. 2016;21(46):30402.  https://doi.org/10.2807/1560-7917.ES.2016.21.46.30402  PMID: 27918268 
  7. Casas-Alba D, de Sevilla MF, Valero-Rello A, Fortuny C, García-García JJ, Ortez C, et al. Outbreak of brainstem encephalitis associated with enterovirus-A71 in Catalonia, Spain (2016): a clinical observational study in a children’s reference centre in Catalonia. Clin Microbiol Infect. 2017;23(11):874-81.  https://doi.org/10.1016/j.cmi.2017.03.016  PMID: 28344164 
  8. González-Sanz R, Casas-Alba D, Launes C, Muñoz-Almagro C, Ruiz-García MM, Alonso M, et al. Molecular epidemiology of an enterovirus A71 outbreak associated with severe neurological disease, Spain, 2016. Euro Surveill. 2019;24(7):1800089.  https://doi.org/10.2807/1560-7917.ES.2019.24.7.1800089  PMID: 30782267 
  9. Kroneman A, Vennema H, Deforche K, v d Avoort H, Peñaranda S, Oberste MS, et al. An automated genotyping tool for enteroviruses and noroviruses. J Clin Virol. 2011;51(2):121-5.  https://doi.org/10.1016/j.jcv.2011.03.006  PMID: 21514213 
  10. Schuffenecker I, Henquell C, Mirand A, Coste-Burel M, Marque-Juillet S, Desbois D, et al. New introductions of enterovirus 71 subgenogroup C4 strains, France, 2012. Emerg Infect Dis. 2014;20(8):1343-6.  https://doi.org/10.3201/eid2008.131858  PMID: 25061698 
  11. Akhmadishina LV, Govorukhina MV, Kovalev EV, Nenadskaya SA, Ivanova OE, Lukashev AN. Enterovirus A71 Meningoencephalitis Outbreak, Rostov-on-Don, Russia, 2013. Emerg Infect Dis. 2015;21(8):1440-3.  https://doi.org/10.3201/eid2108.141084  PMID: 26196217 
  12. Fischer TK, Nielsen AY, Sydenham TV, Andersen PH, Andersen B, Midgley SE. Emergence of enterovirus 71 C4a in Denmark, 2009 to 2013. Euro Surveill. 2014;19(38):20911.  https://doi.org/10.2807/1560-7917.ES2014.19.38.20911  PMID: 25306878 
  13. Huang MC, Wang SM, Hsu YW, Lin HC, Chi CY, Liu CC. Long-term cognitive and motor deficits after enterovirus 71 brainstem encephalitis in children. Pediatrics. 2006;118(6):e1785-8.  https://doi.org/10.1542/peds.2006-1547  PMID: 17116698 
  14. Chang LY, Lin HY, Gau SS, Lu CY, Hsia SH, Huang YC, et al. Enterovirus A71 neurologic complications and long-term sequelae. J Biomed Sci. 2019;26(1):57.  https://doi.org/10.1186/s12929-019-0552-7  PMID: 31395054 

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