Surveillance Data

Summary of 2022 NESS Data

  • NESS received data for 353 specimens that tested positive for either an enterovirus or parechovirus and had a serotype result.
  • In addition to the CDC laboratory, labs from 4 states reported to NESS in 2022.
  • Enterovirus D68 (EV-D68) was the most frequently reported enterovirus type (41.1%). There was a large, nationwide outbreak of respiratory illness associated with EV-D68 in 2022 and there is also a specific test for EV-D68, which might mean that this virus is more likely to be detected and reported, as compared to other enteroviruses. These factors might contribute to the number of EV-D68 detections reported to NESS.
  • The second most frequently reported virus type in 2022 was human parechovirus 3 (20.7%). In July 2022, in response to reports of neonatal and infant parechovirus infections from clinicians in multiple states, a Health Alert Network (HAN) health advisory was released, and the CDC lab offered parechovirus testing and typing for infants with severe disease or suspected parechovirus infection. This might contribute to the number of parechovirus detections reported to NESS.
  • It is also noteworthy that two poliovirus specimens were reported to NESS in 2022. These specimens were from the paralytic polio case patient identified in New York State and were determined to be vaccine-derived poliovirus type 2 (VDPV2) that was genetically linked to virus found in wastewater in the United Kingdom, Israel, and Canada.
  • Among those with a known specimen source, the most common specimen sources were throat/nasopharyngeal (NP) swab (58.9%), cerebrospinal fluid (27.4%), and stool/rectal swab (9.1%).

Most Common Enteroviruses and Parechoviruses Reported in the U.S., 2022*

Most Common Enteroviruses and Parechoviruses Reported in the U.S., 2022
Enterovirus or parechovirus type Proportion of positive specimens Number of positive specimens
Enterovirus D68 41.1% 145
Human Parechovirus 3 20.7% 73
Coxsackievirus A6 5.4% 19
Coxsackievirus A9 5.1% 18
Coxsackievirus B3 4.5% 16
Coxsackievirus B5 4.2% 15
Echovirus 11 2.5% 9
Enterovirus A71 2.3% 8
Coxsackievirus B2 1.7% 6
Coxsackievirus A4 1.4% 5
Echovirus 6 1.4% 5
Echovirus 9 1.4% 5
Coxsackievirus A16 1.1% 4
Coxsackievirus B4 1.1% 4
Echovirus 25 0.8% 3
Coxsackievirus A10 0.6% 2
Echovirus 14 0.6% 2
Echovirus 30 0.6% 2
Echovirus 5 0.6% 2
Human Parechovirus 4 0.6% 2
Human Parechovirus 6 0.6% 2
Poliovirus 2 0.6% 2
Coxsackievirus A15 0.3% 1
Coxsackievirus A2 0.3% 1
Coxsackievirus A5 0.3% 1
Coxsackievirus B1 0.3% 1

NOTE: Multiple specimens from the same patient can be reported to NESS, so the number of specimens does not necessarily correspond to the number of patients affected.

* NESS is a voluntary, passive surveillance system and is limited to laboratories that perform serotyping for enteroviruses and/or parechoviruses. Non-polio enterovirus and parechovirus infections are not mandated reportable conditions in the United States, so not all detections are reported to NESS. In addition, most laboratories do not have the capacity to perform serotyping on enterovirus and parechovirus specimens, and serotyping is not routinely performed as part of clinical care. Therefore, NESS data are not necessarily representative of all enterovirus or parechovirus infections in the United States and should be interpreted with caution. Read more about how public health professionals collect and use NESS data.