Enterovirus D68

What is EV-D68? 

Enterovirus D68 (EV-D68) is a respiratory virus that can cause serious complications for vulnerable populations, particularly children with a history of asthma or wheezing. EV-D68 is considered a relatively rare virus in the United States, though there have been small outbreaks detected as recent as 2014.

What are the symptoms of EV-D68? 

While enteroviruses are ever-present, you are more likely to be infected with one in the summer or fall. The EV-D68 strain can cause mild to severe respiratory illness, or in some cases, no symptoms at all. EV-D68 affects the entire respiratory system — nose, mouth, trachea (windpipe), and lungs — so children with asthma may have a higher risk for severe respiratory illness if infected.

  • Mild symptoms are generally cold-like and may include sneezing, coughing, runny nose, body and muscle aches.
  • Severe symptoms may include wheezing and difficulty breathing.

How do children get EV-D68? 

Like other viruses, EV-D68 spreads easily, most often through coughs, sneezes, or contact with common surfaces (think of a child who rubs his nose, then passes a crayon to a friend).

How is EV-D68 treated? 

The vast majority of people who are sickened by an enterovirus, including EV-D68, have mild symptoms and can treat their illness like the common cold, with fluids and rest.  According to the American Academy of Pediatrics, a number of children have had unusually severe cases of EV-D68 resulting in hospitalization; some requiring treatment in the intensive care unit. While some of these children had asthma, others had no history of respiratory illness.

How can EV-D68 be prevented? 

Currently, there is no vaccination to ward off EV-D68. To reduce your family’s risk of EV-D68, you’ll want to follow the same steps you take to prevent other illnesses, including: 

1. Reinforce good hygiene. The best strategies for reducing risk of EV-D68 are the same as those for any virus: 

  • All family members should wash their hands often (when returning home, after using the bathroom or changing a diaper, after using a tissue, before eating or preparing food). Use soap, warm water, and plenty of friction for at least 20 seconds (equal to a couple of verses of “Twinkle, Twinkle Little Star”). 
  • Disinfect common surfaces (doorknobs, light switches, faucet handles) and change hand towels regularly. 
  • Avoid contact with people who are sick, and avoid others if you develop symptoms. 
  • Don’t share food or drink. 
  • Cover your mouth or nose during coughing or sneezing. If a tissue is not handy, use your elbow or the back of your forearm to catch the germs. 
  • Keep your hands away from your face. 

2. Listen to your child—literally. A runny nose or a bit of a cough isn’t cause for alarm, but if you hear wheezing or your child has any difficulty breathing, call your child’s doctor or seek emergency care.

3. Treat asthma effectively. People with asthma are at greater risk for wheezing. Make sure that your child is taking her medicine as directed and that her asthma is under control. Keep any inhalers accessible. 

4. Get a diagnosis. The CDC has directed health care providers to “consider EV-D68 as a possible cause of acute, unexplained severe respiratory illness” and to report cases to local or state health departments. That may not improve your child’s health now, but it may shed light on this particular virus that could help with prevention, diagnosis, and treatment in the future. 

When should I call a doctor? 

For many people who get EV-D68, the virus can be treated like any common cold. However, if your child has a high fever or cold symptoms lasting longer than 7–10 days, contact your child’s doctor. If your child has difficulty breathing, seek emergency care.

For more information about EV-D68, visit the CDC and American Academy of Pediatrics (AAP) websites.

Last updated March 22, 2020

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