What You Need to Know About Enterovirus D68

There are enough health scares in the news today to cause anxiety in just about everyone: Ebola and enterovirus strain D68, to name just a couple.

But while Ebola is still (and hopefully will remain) an unlikely epidemic, the potentially virulent D68 has set off alarms among parents and health-care providers.

Enteroviruses, which are common in late summer and early fall, are a diverse group of viruses. Most enterovirus strains result in mild illnesses that occur in children. This year has been unique in that many cities across the country reported an increase in moderate and severe respiratory illnesses, the majority of which were positive for enterovirus. Additional testing identified the majority of these as enterovirus D68, the strain that can be associated with more significant respiratory disease and asthma-like symptoms such as wheezing. The virus is the cause of at least six deaths, and is also is being eyed as possible factor in muscle weakness and paralysis in at least 27 children and adults in a dozen states.

“It is very important that parents understand that many respiratory viruses can sicken children, particularly in the winter months,” said Dr. Larry Kociolek, M.D., an infectious disease expert at Ann & Robert H. Lurie Children’s Hospital of Chicago. “Enterovirus is not unique in that regard. Children who have shortness of breath should seek care in an emergency department.”

At Lurie Children’s Hospital, results were typical for the season with 40 percent of patients testing positive for some type of enterovirus or rhinovirus (the cause of the common cold), and only five confirmed cases of D68. Among the hardest-hit cities—Denver and Kansas City—between 75 and 90 percent of symptomatic children were testing positive for an enterovirus/rhinovirus, and the majority of those were confirmed to be D68.

The number of confirmed cases could jump higher in the coming weeks as the Centers for Disease Control and Prevention starts using a new test to help the agency process four or five times more specimens per day than it has been handling.

Even with confirmed cases potentially on the rise with the backlog of specimens working their way through the system, the worst of the enteroviruses, strain D68, is likely behind us.

Now, health-care providers are looking ahead at a season of influenza, a family of respiratory viruses that commonly cause illness every winter and for which is there is a vaccine against as many as four different strains. And people should take all normal precautions against the spread of influenza: frequent hand-washing, not sharing drinks and food with others, and staying home from school or work when becoming ill.

“It’s always a challenge to predict how severe our influenza season will be,” Kociolek says. “Hopefully vaccination rates will improve this year, which will reduce the number of children and adults becoming ill from influenza. I cannot stress enough that influenza vaccine is safe and effective.”