Enterovirus D68 Confirmed in More Than Half of US States

Entervirus D68 cases likely to increase as infection season continues, says CDC

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Cases of children with respiratory illnesses caused by enterovirus D68 (EV-D68) are popping up all over the US. On Wednesday, US health officials released the latest case numbers.

The Centers for Disease Control and Prevention (CDC) has confirmed that, from mid-August to Sept. 24, a total of 220 people in 32 states have developed respiratory illnesses caused by EV-D68. All but one of these cases have been among children.

EV-D68 can cause mild to severe respiratory illness, the CDC reports. Symptoms of mild illness may include fever, runny nose, sneezing, cough, and body and muscle aches. Severe symptoms may include trouble breathing and wheezing.

While anyone can get enteroviruses, infants, children and teens are often most likely to become ill. These young people have a higher risk because their immune systems have not yet gained protection though being exposed to these viruses before.

The low number of reported cases in the current outbreak might be partially explained by the fact that health care professionals are not required to report EV-D68 cases. Thus, the CDC does not know exactly how many infections and deaths from the virus happen each year.

"Enterovirus D68 is a virus that has caused sporadic outbreaks of respiratory tract illness in the US since the 1960s," explained Steven Davis, MD, an infectious disease specialist at Baylor Medical Center at Irving. Scientists first discovered EV-D68 in California in 1962, but the virus has seldom been reported in the US since.

"The virus has recently been recognized as causing respiratory disease this summer and fall in children," Dr. Davis said. "The outbreak was first recognized in the Midwest, but has sent many youngsters to the emergency department in many states now."

In the last couple of months, the CDC has tracked confirmed cases of illness caused by EV-D68. The 32 states with confirmed cases include Alabama, Arkansas, California, Colorado, Connecticut, District of Columbia, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Utah, Virginia, Washington and West Virginia.

In Missouri and Illinois, many of the children who got very sick with EV-D68 had asthma or a history of wheezing.

"Interestingly, many children have no or only low grade fever," Dr. Davis said. "Children who have underlying asthma may be particularly at risk for severe asthma attacks and should seek care promptly if this occurs."

According to the CDC, more states will have confirmed cases of EV-D68 infection in coming weeks.

One reason for these increases, the CDC reports, is that many states are testing for EV-D68 in clusters of people with severe respiratory illness. Getting lab results for such tests can take some time.

Another likely reason for the increase in EV-D68 cases is that risk for enterovirus infection is higher in the summer and fall — which include August and September.

The CDC is urging doctors to report suspected clusters of severe respiratory illness to local and state health departments.

There is no specific treatment for people who develop illness from EV-D68 infection. People who develop mild illness may be able to relieve symptoms with over-the-counter medications for pain and fever. Hospitalization may be needed for some people who develop severe illness.

"Most persons recovery completely from the enterovirus D68 respiratory illness," Dr. Davis reassured.

The CDC offers some advice to protect against respiratory illnesses:

  • Wash your hands often with soap and water for 20 seconds. It's especially important to wash your hands after changing diapers.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick.
  • Disinfect surfaces that people touch often. Such surfaces may include toys and doorknobs.
Review Date: 
September 25, 2014
Last Updated:
October 8, 2014