Enterovirus D68 (EV-D68)
What are enteroviruses?
Enteroviruses are very common viruses that can cause respiratory illness, fever and rash, and neurologic illnesses, such as aseptic meningitis (swelling of the tissue covering the brain and spinal cord) and encephalitis (swelling of the brain); there are more than 100 types of enteroviruses.
Approximately 10 to 15 million enterovirus infections occur in the United States 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.
Enterovirus D68 (EV-D68) is causing outbreaks of respiratory infection in multiple US states this year. The outbreaks are resulting in significant numbers of children requiring emergency department visits and hospitalizations, primarily for difficulties with breathing and severe asthma. Children with asthma appear to be more susceptible to serious illness from EV-D68.
How does enterovirus spread?
Because EV-D68 has been uncommon in the past, the ways it spreads are not as well- understood as other enteroviruses. EV-D68 causes respiratory illness, and the virus can be found in respiratory secretions such as saliva, nasal mucus, or sputum. The virus likely spreads from person to person when an infected person coughs, sneezes, or a person touches contaminated surfaces.
What are the symptoms of EV-D68?
EV-D68 has been reported to cause mild to severe respiratory illness (runny nose, cough, difficulty breathing) with and without fever. A minority of people may have more serious infections, particularly children with pre-existing asthma. Because EV-D68 has previously been uncommon in the US, we are still learning about the illness and risk factors for infection. As we learn more, information about EV-D68 infection will be updated. Most people with other enterovirus infections have mild illness that does not require medical care or evaluation.
Use the same judgment as usual about when to see (or take a child to see) a health care provider:
Anyone who has difficulty breathing or who appears seriously ill should be evaluated promptly by a healthcare provider. Persons with asthma should be sure their asthma symptoms are under control, and see a health care provider if they develop respiratory symptoms and their asthma worsens. Adults and children with non-severe enterovirus infections do not need to see a health care provider and do not need to be tested.
How is EV-D68 diagnosed and treated?
Many hospitals can test for enteroviruses in hospitalized patients, but they are probably not able to identify EV-D68. Public Health can assist with EV-D68 testing in hospitalized patients after consultation with health care providers. Patients who are not seriously ill do not need to be tested.
There is no specific treatment for EV-D68 infections. Some people with severe respiratory illness caused by EV-D68 may need to be hospitalized and receive intensive supportive therapy. Because children with asthma may be at increased risk for more serious EV-D68 infections, it is a good idea to be sure asthma symptoms are under control.
How can enterovirus infection be prevented?
There is no vaccine for enterovirus infections. To decrease the risk for enterovirus infections:
• Wash hands often with soap and water for 20 seconds (alcohol hand gel is not as good as hand washing for enteroviruses)
• Avoid touching eyes, nose and mouth with unwashed hands
• Avoid contact with ill people
• Do not go to day care, school or work while ill
• 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
• Children and adults with asthma should be sure to have their asthma symptoms under control and see a health care provider if they develop a respiratory infection and their asthma worsens