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J Gen Virol. 2012 Sep;93(Pt 9):1952-1958. doi: 10.1099/vir.0.043935-0. Epub 2012 Jun 13.

Worldwide emergence of multiple clades of enterovirus 68.

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Center for Infection and Immunity, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1701, NY 10032, USA.
Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa.
National Institute of Communicable Diseases, Division of National Health Laboratory Service, Sandringham, Johannesburg, 2131, South Africa.
Child Survival Theme, Medical Research Council Unit, PO Box 273, Banjul, The Gambia.
New York City Department of Health and Mental Hygiene, Gotham Center, 42-09 28th St, New York, NY 11101, USA.


Human enterovirus 68 (EV-D68) is a historically rarely reported virus linked with respiratory disease. In the past 3 years, a large increase in respiratory disease associated with EV-D68 has been reported, with documented outbreaks in North America, Europe and Asia. In several outbreaks, genetic differences were identified among the circulating strains, indicating the presence of multiple clades. In this report, we analyse archived and novel EV-D68 strains from Africa and the USA, obtained from patients with respiratory illness. Phylogenetic analysis of all EV-D68 sequences indicates that, over the past two decades, multiple clades of the virus have emerged and spread rapidly worldwide. All clades appear to be currently circulating and contributing to respiratory disease.

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