What to know about Enterovirus D68

Child covering their mouth coughing with three gray germ cells circling above them
Enterovirus D68 cases in pediatric hospitals have risen again since the 2014 outbreak. (Image: Adobe Stock; Illustration: Sebastian Stankiewicz/Boston Children's)

By now you’ve seen the news: Several health care providers and hospitals across the United States during August 2022 identified an increase in pediatric hospitalizations due to a virus causing children to develop coughing and breathing problems that are often more severe than the common cold. That virus is Enterovirus D68 (EV-D68) and it’s just one strain of Enteroviruses, which cause colds, fever, headaches, vomiting, and rashes among other symptoms. Most Enterovirus infections are very common and spread quickly primarily among children. EV-D68, however, is an unusual strain.

Not only is it much less common than other Enteroviruses, but it can also cause especially bad respiratory illnesses, including a bad cough and difficulty breathing. In some cases, children and other patients with EV-D68 have needed ICU-level care and the assistance of a mechanical ventilator. EV-D68 can be especially dangerous for children with existing lung problems (like asthma) or who have weaker immune systems (like newborns). In 2014, there was a large outbreak of EV-D68 from mid-August 2014 until January 2015. Almost all of the confirmed cases were children — many of whom had asthma or a history of wheezing. This was the first documented nationwide outbreak of the EV-D68, and now we’re taking a closer look at the current uptick in cases once again.

The Centers for Disease Control and Prevention (CDC) is monitoring the situation closely. Like any other virus, EV-D68 spreads from person to person through bodily fluids — think saliva and nasal mucus — as well as through sneezes, handshakes, changing diapers, and many other kinds of interactions.

Although EV-D68 seems to affect children more than adults, it may be that adults who become infected show much less severe symptoms. There are no vaccines or antiviral therapies for EV-D68 and care is supportive, meaning that all hospitals can do is provide relief for the symptoms. So it’s important that adults who are around children take precautions to minimize the risk of spreading the virus.

Here are some things you can do to help prevent the spread:

  • Wash your hands often with soap and water for 20 seconds.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact such as kissing, hugging, and sharing cups or eating utensils with people who are sick, and when you are sick.
  • Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands.
  • Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
  • Stay home when you are sick.
  • Consider wearing a mask around other people if you have respiratory symptoms.
  • Contact a healthcare provider immediately if you or your child has trouble breathing or has a sudden onset of limb weakness.
  • Ensure you or your child are following an up-to-date asthma action plan if you or your child have asthma.
  • Stay up-to-date with all recommended vaccines.

For more information about EV-D68, visit the CDC at https://www.cdc.gov/non-polio-enterovirus/about/ev-d68.html#outbreak.

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