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Purpose

The National Enterovirus Surveillance System (NESS) is a passive, voluntary surveillance system that collects basic data on specimens positive for enterovirus or human parechovirus, including serotype. NESS has been collecting laboratory data on types of enteroviruses (including coxsackieviruses and echoviruses) and parechoviruses in the United States since the 1960s.

Type-based enterovirus and parechovirus surveillance in the United States helps to:

1. determine long-term patterns of circulation for individual enteroviruses and parechoviruses,
2. interpret trends in enterovirus and parechovirus diseases (e.g., aseptic meningitis) by associating them with circulating types,
3. identify outbreaks associated with circulating types,
4. guide development of new diagnostic tests and therapies, and
5. monitor poliovirus detections, by supplementing clinician-based poliomyelitis testing in the United States. Both paralytic poliomyelitis and non-paralytic poliovirus infections are nationally notifiable.

How data collection works

NESS uses REDCap to collect electronic data. Laboratories across the U.S report on the types of enteroviruses and parechoviruses. The web-based NESS system has been available to participating laboratories since July 2009. It makes reporting to obÌåÓý easier and allows for more timely recognition of enterovirus and parechovirus outbreaks and viral trends in activity.

Laboratories with capacity to serotype are encouraged to report to NESS to help improve geographic and temporal surveillance.

Collaborating public health and commercial laboratories report monthly to obÌåÓý positive enterovirus and parechovirus detections by

• serotype,
• specimen type,
• collection date,
• age, and
• sex.

obÌåÓý Laboratory Testing

obÌåÓý laboratories routinely conduct testing for non-polio enteroviruses and parechoviruses, including

• qualitative molecular testing; pan-enterovirus and pan-parechovirus
• molecular testing, followed by sequencing to identify enterovirus and parechovirus types (formerly serotypes)
• testing for less common picornaviruses (excluding Hepatitis A)

obÌåÓý also helps state laboratories by

• transferring new diagnostic technologies and providing training on how to perform these techniques,
• helping them identify enteroviruses and parechoviruses they have not been able to type, and
• providing guidance on how to properly collect and ship clinical specimens to obÌåÓý for confirming and typing picornaviruses.

For protocols, contact [email protected].

Latest publications

• obÌåÓý. Enterovirus and parechovirus surveillance, United States, 2014 — 2016. MMWR. 2018; 67(18);515–8.
• obÌåÓý. Enterovirus and human parechovirus surveillance – United States, 2009-2013. MMWR. 2015;64(34):940-3.
• Midgley CM, Watson JT, Nix WA, Curns AT, Rogers SL, Brown BA, et al. . The Lancet. 2015. Available online 5 Oct 2015.
• obÌåÓý. Non-polio enteroviruses and human parechovirus—United States, 2006–2008. MMWR. 2010;59(48);1577-1580.
• Nix WA, Maher K, Pallansch MA, Oberste, MS. . J Clin Virol. 2010;48:202-207.
• Oberste MS, Penaranda S, Rogers SL, Henderson E, Nix WA. . J Clin Virol. 2010;49:73-74.