Mighty Blog

The facts about enterovirus D68

Suspected cases of enterovirus D68 infections recently have popped up, with 12 states (Minnesota and Wisconsin are not included to date) contacting the Centers for Disease Control and Prevention for help confirming test samples.

It is not a mystery virus – we see it every late summer/early fall. What is different is that this particular strain, EV-D68, seems to be causing more intense asthma symptoms, wheezing and respiratory difficulty for a large number of kids at the same time.

Now is as good a time as ever to learn about EV-D68 and enteroviruses in general.

CDC background on enteroviruses

  • Enteroviruses are common viruses – there are more than 100 types.
  • Most enterovirus infections in the U.S. occur seasonally during the summer and fall, peaking in September.
  • It’s estimated that 10 million to 15 million enterovirus infections occur in the U.S. each year.
  • Most people infected with enteroviruses have no symptoms or only mild symptoms, but some infections can be serious.
  • Infants, children and teenagers are most likely to get infected with enteroviruses and become sick. Infants and people with weakened immune systems are at risk of the virus worsening into heart or brain infections.

How is enterovirus spread?

“Enteroviruses can be spread by close contact with an infected person who may cough or sneeze on you and by touching objects or surfaces that have the virus on them and then touching your eyes, nose or mouth,” said Patsy Stinchfield, pediatric nurse practitioner and Children’s director of infectious disease and prevention.

Enterovirus D68

Enterovirus D68 is one of many enteroviruses. EV-D68 infections are thought to occur less commonly than infections with other enteroviruses. It first was identified in California in 1962. Compared with other enteroviruses, EV-D68 has been rarely reported in the U.S. in the past 40 years. There have been no known deaths due to the 2014 virus.

What are EV-D68 symptoms?

EV-D68 usually can cause mild to severe respiratory illness; however, the full spectrum of EV-D68 illness is not well-defined. Most people who get infected are infants, children and teens. Most start with common cold symptoms of runny nose and cough. Some, but not all, may also have fever.  For more severe cases, difficulty breathing, wheezing or problems catching your breath may occur.

How should I care for my child if I suspect enterovirus D68?

There is no specific treatment for EV-D68 infections. Many infections will be mild and self-limited, requiring only treatment of the symptoms such as increasing fluids and rest or fever-reducing medicine.

Some people with severe respiratory illness caused by EV-D68 may need to be hospitalized and receive supportive therapy such as oxygen and nebulizations. There are no anti-viral medications or vaccines currently available for EV-D68 treatment or prevention.

What do I do if my child has these symptoms?

If your child has these symptoms, Stinchfield says: 

  1. If symptoms are mild, such as common cold, parents should do what they normally do with a sick child – increase his or her fluids, rest, keep home from school, give fever- and pain-reducing medicines.
  2. If symptoms are moderate, such as cold symptoms worsening or not getting better within a week, or new wheezing begins, take your child to your clinic.
  3. If at any time your child is having difficulty breathing or you are seeing blue lips or they are gasping for air, take him or her to the closest emergency room. 

How do I prevent enterovirus?

There are no vaccines for preventing EV-D68 infections.

Ways to help reduce the risk of getting infected with EV-D68:

  • Superb hand hygiene is important. Wash hands often with soap and water for 20 seconds, especially after changing diapers.
  • Avoid touching eyes, nose and mouth with unwashed hands.
  • Avoid kissing, hugging and sharing cups or eating utensils with people who are sick.
  • Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
  • Cover coughs and sneezes.
  • Stay home if you’re ill.

How do I know if my child has enterovirus D68 or another respiratory illness?

Fall and winter seasons see many different viruses circulating in the community. Some of them that look similar with cough and runny nose include:

Respiratory syncytial virus (RSV) is a respiratory virus that infects the lungs and breathing passages. Most otherwise healthy people recover from RSV infection in one to two weeks. However, infection can be severe in some people, such as infants, young children and older adults. RSV is the most-common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children younger than 1 year of age in the U.S. RSV is more often being recognized as an important cause of respiratory illness in older adults.

Influenza (flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications. The best way to prevent the flu is by getting vaccinated each year – Children’s is hosting vaccination clinics at Kohl’s stores around the Twin Cities metro area.