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Enterovirus D68

Non-polio enterovirus

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Description

Enterovirus D68 (EV-D68) is a virus that causes flu-like symptoms that range from mild to severe.

EV-D68 was first discovered in 1962. Until 2014, this virus was not common in the United States. In 2014, an outbreak occurred across the country in nearly every state. Many more cases have occurred than in the years past. Nearly all have been children.

Who Gets the Virus?

Infants and children are most at risk for EV-D68. This is because most adults are already immune to the virus because of past exposure. Adults may have mild symptoms or none at all. Children are more likely to have severe symptoms. Children with asthma are at higher risk for severe illness. They often have to go to the hospital.

Symptoms

Symptoms can be mild or severe.

Mild symptoms include:

• Fever
• Runny nose
• Sneezing
• Cough
• Body and muscle aches

Severe symptoms include:

• Wheezing
• Difficulty Breathing

How the Virus Spreads

EV-D68 is spread through fluids in the respiratory tract such as:

• Saliva
• Nasal fluids
• Phlegm

The virus can be spread when:

• Someone sneezes or coughs.
• Someone touches something a sick person has touched and then touches his own eyes, nose, or mouth.
• Someone has close contact such as kissing, hugging, or shaking hands with someone who has the virus.

Diagnosis

EV-D68 can be diagnosed by testing fluid samples taken from the throat or nose. Samples must be sent to a special lab for testing. Tests often aren't done unless someone has severe illness with unknown cause. These patients are typically hospitalized.

Treatment

There is no specific treatment for EV-D68. In most cases, the illness will go away on its own. You can treat symptoms with over-the-counter medicines for pain and fever. Do not give aspirin to children under the age of 18.

People with severe breathing problems should go to the hospital. They will receive treatment to help relieve symptoms.

How to Prevent the Virus from Spreading

There is no vaccine to prevent EV-D68 infection. But you can take steps to prevent spreading the virus.

• Wash your hands often with soap. Teach your children to do the same.
• Do not put unwashed hands around your eyes, mouth, or nose.
• Do not share cups or eating utensils with someone who is sick.
• Avoid close contact such as shaking hands, kissing, and hugging people who are sick.
• Cover coughs and sneezes with your sleeve or a tissue.
• Clean touched surfaces such as toys or doorknobs often.
• Stay home when you are sick and keep your children home if they are sick.

Protecting Children with Asthma

Children with asthma are at increased risk for severe illness from EV-D68. The CDC makes the following recommendations to help keep your child safe:

• Be sure your child's asthma action plan is up to date and that you and your child both understand it.
• Make sure your child continues to take asthma medicines.
• Always be sure your child has reliever medicines.
• Make sure your child gets a flu shot and COVID-19 vaccine.
• If asthma symptoms worsen, follow the steps in the asthma action plan.
• Call your health care provider right away if the symptoms do not go away.
• Be sure your child's teachers and caretakers know about your child's asthma and what to do to help.

When to Call the Doctor

If you or your child with a cold has a hard time breathing, contact your provider right away or get emergency care.

Also, contact your provider if your symptoms or your child's symptoms are getting worse.

References

Centers for Disease Control and Prevention website. About Enterovirus D68. www.cdc.gov/non-polio-enterovirus/about/about-enterovirus-d68.html?CDC_AAref_Val=https://www.cdc.gov/non-polio-enterovirus/about/EV-D68.html. Updated April 11, 2024. Accessed June 19, 2024.

Romero JR. Coxsackieviruses, echoviruses, and numbered enteroviruses (EV-A71, EVD-68, EVD-70). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 172.

Seethala R, Takhar SS, Bullard-Berent J, Banks LL. Viruses. In: Walls RM, Hockberger RS, Gausche-Hill M, Erickson TB, Wilcox SR, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 119.

Review Date: 8/26/2023  

Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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