Infectious Diseases

EV-D68 (Enterovirus Infection)

EV-D68 (Enterovirus Infection) is also known as EV-D68 and may cause respiratory illness. Most reported cases of EV-D68 have involved children, however adults may also develop illness from being infected by the virus.

EV-D68 is one type of many non-polio enteroviruses. In the United States, people are more likely to get infected with enteroviruses in the summer and fall, and EV-D68 infections are likely to decline later in the fall.

See a healthcare provider right away if you, your child, or someone in your care is sick with a cold and has difficulty breathing, or if symptoms get worse. Other viruses besides EV-D68 can cause similar respiratory illness and also circulate during this same time of year, so be sure to follow a doctor's recommendations for treatment and care.

EV-D68 infections are thought to occur less commonly than infections with other enteroviruses. However, the U.S. Centers for Disease Control and Prevention (CDC) does not know how many infections and deaths from EV-D68 occur each year in the United States. Healthcare professionals are not required to report this information to health departments, however rare or unusual clusters and outbreaks of such illnesses are reportable.

Since August of 2014, there has been a nationwide outbreak of respiratory illness caused by Enterovirus D68 (EV-D68), mostly affecting children. EV-D68 appears to be the most common type of enterovirus this year and this virus may be involved in many cases of severe respiratory illnesses being seen throughout the U.S. EV-D68 has also been confirmed to be circulating in Rhode Island. More

At-Risk Populations

In general, infants, children, and teenagers are most likely to get infected with enteroviruses and become ill. That's because they have not yet built immunity (the body's protection) from being previously exposed to these viruses.

Among the EV-D68 cases reported nationwide in 2014, children with asthma seemed to have a higher risk for the most severe symptoms of respiratory illness.

Symptoms

Mild symptoms may include:

Fever
Runny nose
Sneezing
Cough
Body and muscle aches.

Patients who are very ill with EV-D68:

Have difficulty breathing
May or may not have fever
May or may not experience wheezing. (Many children with severe illness have had asthma or wheezing in the past.)

Note that respiratory illnesses can be caused by many different viruses that can cause similar symptoms and not all respiratory illnesses are due to EV-D68. Anyone with respiratory illness who has difficulty breathing, or see symptoms getting worse should call a healthcare provider.

How It Spreads

Enteroviruses are transmitted through close contact with an infected person, or by touching objects or surfaces that are contaminated with the virus and then touching the mouth, nose, or eyes.

Since EV-D68 causes respiratory illness, the virus can be found in an infected person's respiratory secretions, such as saliva, nasal mucus, or sputum. EV-D68 likely spreads from person to person when an infected person coughs, sneezes, or touches contaminated surfaces.

Prevention

There is no immunization nor specific antiviral medication for enterovirus infections.

Like the flu, respiratory illness caused by EV-D68 is best prevented by frequent hand washing and good hygiene. To stop the spread of enteroviruses and other seasonal illness such as flu, everyone should:

Wash hands often with soap and water for 20 seconds, especially after using the bathroom, changing diapers, coughing or sneezing, and before eating or preparing food.
Avoid touching eyes, nose and mouth with unwashed hands.
Avoid kissing or hugging people who are sick, or when sick.
Avoid sharing dishes or eating utensils with people who are sick, or when sick.
Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
Cover your cough; Cough into elbowsâ€”not hands.
Discard used tissues right away.

Talk with your child's doctor about how best to manage your child's asthma and to ensure a care plan is in place to help prevent more severe illness from developing in the event of an infection or illness. Get more information for parents and caregivers about asthma.

Testing & Diagnosis

EV-D68 can only be diagnosed by doing specific lab tests on specimens from a person's nose and throat.

Many hospitals and some doctor's offices can test ill patients to see if they have enterovirus infection. However, most cannot do specific testing to determine the type of enterovirus, like EV-D68. Some state health departments and CDC can do this sort of testing.

CDC recommends that clinicians only consider EV-D68 testing for patients with severe respiratory illness and when the cause is unclear.

Treatment

There is no specific treatment for people with respiratory illness caused by EV-D68. For mild respiratory illness, you can help relieve symptoms by taking over-the-counter medications for pain and fever. Aspirin should not be given to children.

Some people with severe respiratory illness may need to be hospitalized to be closely monitored and receive supportive care (for example, intubation).

There are no antiviral medications currently available for people who become infected with EV-D68.

Parents with children who have asthma should have a care plan in place with their healthcare provider and follow the plan in the event of any illness.