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What is enterovirus D68?
Enterovirus D68 (EV-D68) is a respiratory illness that most often affects babies, children, and teenagers. The illness is usually mild, though some children – especially those with asthma – can have severe symptoms.
A small number of cases are reported to the Centers for Disease Control (CDC) each year, but a nationwide outbreak of EV-D68 occurred between August 2014 and January 2015. During that period, 1,153 people in 49 states and the District of Columbia were diagnosed with the viral illness – almost all of them children.
What are the symptoms of enterovirus D68?
Mild symptoms may include:
- Runny nose
- Body and muscle aches
Severe symptoms may include wheezing and difficulty breathing. Call 911 if your child has trouble breathing.
How does enterovirus D68 spread?
Enterovirus D68 can spread through close contact with an infected person because their saliva, nasal secretions, and phlegm contain the virus. You can also get infected if you touch your mouth, eyes, or nose after touching surfaces or objects contaminated with the virus.
In other words, it spreads the same way that many common viruses (such as cold viruses) do.
Is it true that enterovirus D68 causes acute flaccid myelitis (AFM)?
We don't yet have the answer.
Some children with EV-D68 developed acute flaccid myelitis, an unexplained weakness in one or more limbs that can lead to paralysis in some cases. However, other children with AFM did not test positive for EV-D68. Experts are continuing to explore a possible link and search for the cause of AFM.
Although the number of AFM cases has increased since 2014, keep in mind that it remains a very rare condition – the chances of getting AFM are less than 1 in a million.
For more information, check out the EV-D68 and AFM resources from the CDC.
At what time of year are people most likely to get infected with enterovirus D68?
In the United States, enterovirus infections are more common in the summer and fall, though they can happen any time of year.
Who is at risk for enterovirus D68?
According to the CDC, almost all confirmed cases of EV-D68 have been in children. In general, babies, children, and teenagers are more likely than adults to become ill from an enterovirus infection because they don't yet have immunity from previous exposures to these viruses.
Many children diagnosed with EV-D68 have asthma or a history of wheezing. Children with asthma who are infected may have unusually severe respiratory symptoms that require hospitalization.
Adults can be infected by an enterovirus but are more likely to have mild symptoms or none at all.
How is enterovirus D68 diagnosed?
Enterovirus D68 is diagnosed by testing blood samples or swabs taken from the nose and throat. The CDC and some state health departments can do this sort of testing when it's warranted.
Many hospitals and some doctor's offices can test patients to see if they have some kind of enterovirus infection, but most can't test specifically for type D68. The CDC recommends that healthcare providers consider having patients with severe respiratory illness tested for type D68 when the cause of their illness is unclear. Positive tests help the CDC track the number of EV-D68 cases.
How is enterovirus D68 treated?
There are no antiviral medications and no specific treatments for EV-D68. But the vast majority of children with EV-D68 have mild symptoms and get better with the same type of care used to treat the common cold.
To relieve symptoms such as pain and fever, ask a doctor or pharmacist about giving your child ibuprofen (if your child is at least 6 months old) or acetaminophen. Never give aspirin to anyone younger than 20 because it can cause the rare but potentially fatal illness Reye's syndrome.
The American Academy of Pediatrics (AAP) doesn't recommend over-the-counter cold or cough medicines for children younger than 6 years old. These products aren't safe for children age 3 and younger, according to the AAP. Studies have shown that they don't work in 4- and 5-year-olds and can also have potentially serious side effects. Kids age 6 and older can be given cold and cough medicines as long as dosage instructions are carefully followed.
If symptoms are mild, try safe home remedies for cold, cough, and flu. People with severe symptoms need medical attention right away and may need to be hospitalized.
How can I protect my family from enterovirus D68?
You can try to avoid getting and spreading EV-D68 and other respiratory illnesses by following these steps:
- Wash hands often with soap and water for 20 seconds. See our guide to effective hand-washing techniques for kids and parents.
- Avoid touching your eyes, nose, and mouth.
- Avoid close contact with people who are sick. This includes kissing, hugging, and sharing cups or eating utensils.
- Cover your coughs and sneezes with a tissue or 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're sick.
There are no vaccines for preventing EV-D68 infections.
Are there special precautions for children with asthma or other respiratory conditions?
Yes. Children with asthma and other respiratory problems are at risk for severe symptoms from EV-D68 and other similar illnesses. If your child is in this category, follow these recommendations from the CDC:
- Discuss and update your child's asthma action plan with his or her primary care provider.
- Make sure your child takes prescribed asthma medications as directed – especially long-term control medication.
- Make sure your child always carries rescue medication.
- Have your child get the flu vaccine every year.
- If your child has new or worsening asthma symptoms, follow the steps of his or her asthma action plan. If symptoms don't go away, call your child's provider right away or seek emergency care.
- Make sure your child's caregiver or teacher is aware of the condition and knows how to help if your child develops symptoms related to asthma.
When should I call the doctor?
Call the doctor if:
- Your child's symptoms seem to be getting worse.
- Your child has a high fever. (This is a temperature of 100.4 degrees F or higher in a child younger than 12 weeks, or a temperature above 104 degrees F in a child of any age.)
- Your child has cold symptoms lasting more than seven to 10 days.
Call 911 right away if your child has difficulty breathing, sudden weakness in the arms or legs, or paralysis.