The National Microbiology Center (CNM) of the Carlos III Health Institute (ISCIII) has documented the First detections in clinical samples of minors in Spain from an integervirus (EV) Rare of C105 genotype (EV-C105), associated with respiratory and neurological disease.
The study, published in ‘Eurosurveillance’, has analyzed 2,443 positive samples of EV between January 2019 and December 2024, of which five have been positive for EV-C105. Specifically, One of the positive took place in 2019; two, in 2023; and two others in 2024. It is the first time that this genotype is detected in Spain since in 2006 the surveillance of non-polio enterovirus through molecular methods was established in CNM-ICIII. However, the results coincide with an increase in detections in other European countries, such as the United Kingdom, Slovenia, Italy, the Netherlands and Belgium, which have also registered a rebound since 2023.
Enterovirus are a group of viruses that They can cause a wide variety of diseases, From minor respiratory infections to severe neurological conditions, but even this study had only documented two cases worldwide in which the EV-C105 had been associated with neurological conditions. Thus, this research, in addition to identifying the presence of EV-C105 in respiratory cases, somewhat reflected in most sporadic cases reported in scientific literature, has also detected two neurological cases, referring to two hospitalizations for meningitis and acute flaccid paralysis.
In addition, phylogenetic analysis of EV-C105 strains detected in Spain have revealed that Four of them belong to a new emerging lineage, called C1. This lineage is distinguished by four mutations in key regions of the virus, which could be related to its ability to evade the immune system or to transmit more quickly.
In this context, research highlights the need to strengthen Genomic surveillance to expand the EV-C105 sequence databaseswhich will improve the understanding of its evolution and propagation, and facilitate its surveillance in case there were more strains in C1 that could be causing more neurological infections in children throughout Europe.
Difficulty
The detection of EV-C105 in multiplex PCR panels used in laboratories is complicated because, unlike other enterovirus, this presents a divergent genomic region, called 5′-ut. In this sense, CNM research has used various respiratory panels in participating hospitals to successfully achieve identification. The article indicates that some commercial detection methods may not be able to detect it, which could lead to an infraotification of cases.
Another key aspect indicated in this study is the proper choice of clinical samples. Traditionally, stool and respiratory samples are the most used for the detection of enterovirus in cases of neurological diseases, such as encephalitis or paralysis. However, it has been observed that some respiratory integer, such as EV-D68, which can also cause neurological diseases, are rarely detected in feces. In this line, EV-C105 also presents complications for detection only in feces in patients With neurological diseases, so that for this study the diagnoses of these patients were performed through respiratory samples, since those of feces were negative.
A similar finding seems to occur with the EV-C105, since the two patients with neurological diseases in this study were diagnosed through respiratory samples, while the stool samples were negative. This highlights the importance of including respiratory samples in the surveillance of enterovirus, even in cases that have neurological symptoms. With all this, since EV-C105 is an Enterovirus with little presence in the scientific literature, the conclusions of the study emphasize the need to intensify the genomic surveillance of these viruses and expand the databases with complete genomes to better understand their evolution and transmission, given their Potential to cause serious diseases and their rapid spread in Europe.
In addition, they recommend that clinicians are attentive to possible neurological infections caused by this virus, Especially in children, and suggest that respiratory and feces samples are ensured, since the EV-C105 could represent a “new challenge” for public health in Spain and Europe.
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