RT Journal Article T1 Genomic surveillance of enterovirus associated with aseptic meningitis cases in southern Spain, 2015-2018 A1 Gambaro, Fabiana A1 Belen Perez, Ana A1 Aguera, Eduardo A1 Prot, Matthieu A1 Martinez-Martinez, Luis A1 Cabrerizo, Maria A1 Simon-Loriere, Etienne A1 Dolores Fernandez-Garcia, Maria K1 Y K1 Molecular epidemiology K1 Frequent recombination K1 Evolutionary dynamics K1 Echovirus 30 K1 Emergence K1 Selection K1 Lineages AB New circulating Enterovirus (EV) strains often emerge through recombination. Upsurges of recombinant non-polio enteroviruses (NPEVs) associated with neurologic manifestations such as EVA71 or Echovirus 30 (E30) are a growing public health concern in Europe. Only a few complete genomes of EVs circulating in Spain are available in public databases, making it difficult to address the emergence of recombinant EVs, understand their evolutionary relatedness and the possible implication in human disease. We have used metagenomic (untargeted) NGS to generate full-length EV genomes from CSF samples of EV-positive aseptic meningitis cases in Southern Spain between 2015 and 2018. Our analyses reveal the co-circulation of multiple Enterovirus B (EV-B) types (E6, E11, E13 and E30), including a novel E13 recombinant form. We observed a genetic turnover where emergent lineages (C1 for E6 and I [tentatively proposed in this study] for E30) replaced previous lineages circulating in Spain, some concomitant with outbreaks in other parts of Europe. Metagenomic sequencing provides an effective approach for the analysis of EV genomes directly from PCR-positive CSF samples. The detection of a novel, disease-associated, recombinant form emphasizes the importance of genomic surveillance to monitor spread and evolution of EVs. PB Nature portfolio SN 2045-2322 YR 2021 FD 2021-11-02 LK https://hdl.handle.net/10668/25511 UL https://hdl.handle.net/10668/25511 LA en DS RISalud RD Apr 11, 2025