Enterovirus D68 Infections

.What is Enterovirus D68?

Enterovirus infections typically occur during the summer or fall and usually cause gastrointestinal symptoms such as diarrhea and/or vomiting with or without a rash. However, unlike the typical Enteroviruses, of which there are more than 100 types, Enterovirus D68(EVD68) seems to mainly cause respiratory illness. Symptoms of this infection range from a mild cold-like illness, to coughing and wheezing, to severe infections requiring hospitalization. Of particular importance is that EVD68 tends to infect children and teenagers although it can infect people of any age. EVD68 can be especially severe in persons with underlying respiratory conditions like asthma. In September 2014 clusters of cases of EVD68 infections in the USA and some cases in Canada were reported.

How is Enterovirus D68 spread?

Unlike most other Enteroviruses, EVD68 is spread directly by respiratory droplets just like the common cold and the flu during sneezing or coughing. EDV68 can also spread indirectly by touching surfaces or objects contaminated with these secretions and then by touching the mouth, nose or eyes.

Treatment and prevention of Enterovirus D68 infections

There is no vaccine nor specific treatment for EV-D68. Most children get better on their own or with usual “cold” precautions like acetaminophen for fever control. For people with asthma, as with other viral infections, their asthma symptoms may worsen in which case they would need to use their asthma inhalers more frequently.  Obviously people who have difficulty breathing may require hospitalization for more intensive treatment.

Note that this type of infection and symptom profile is not new, as other viral infections like the flu or Respiratory Syncytial Virus(RSV) can cause similar clusters or outbreaks. The only difference is that EVD68 is relatively new as it was first recognized as a cause of clusters in 2008. The general treatment approach is the same as for other respiratory viruses as is the prevention approach that includes:

  • Washing hands frequently including after touching commonly touched objects and surfaces, before touching your face, before preparing food and before eating
  • Avoiding touching your face as much as possible
  • Staying at least two meters (six feet) away from people who are ill
  • Frequent cleaning of surfaces and objects
  • Staying home if you are sick
  • Coughing and sneezing into your elbow

On a final note, if your child has asthma, you should ensure that their puffers are not empty or expired and are with them at all times. Also make sure you understand your child's specific asthma treatment plan that your doctor has prescribed both for prevention and acute attack situations. If despite use of the inhalers, symptoms persist or worsen, you should seek medical attention right away. Of course, even when a child who does not have asthma develops severe breathing difficulty as a result of this or any other infection, medical attention should also be sought immediately.