Should parents worry about the Enterovirus D68 outbreak?

Updated: Oct. 2, 10:01 a.m.

Enterovirus D68 (EV-D68) has been trending on the nightly newscasts and has probably risen to the top of your social media timelines several times over the past few weeks. Parental fear their children will succumb to a sudden, severe respiratory illness requiring aggressive life-saving interventions. Before rushing your child to the emergency room, make sure you know what Enterovirus D68 is capable of.

According to the Centers for Disease Control and Prevention (CDC), Enterovirus D68 is an uncommon strain of a common family of viruses. Every year, tens of thousands of people are hospitalized every year for illnesses caused by enteroviruses. Typically, the symptoms are similar to a mild cold: runny nose, fever, sneezing, cough and body and muscle aches. The usual duration of illness is about a week and most children recover without significant problems. In this outbreak, the symptoms associated with infection have sometimes been worse than the average cold. They can include neurologic symptoms, and there have been isolated reports that some infected children experience muscle weakness or paralysis. At least 4 out of 9 children in Colorado with muscle weakness in their limbs also tested positive for Enterovirus D68 between August 9 and September 17 of this year. The CDC is looking into a link, but cautions that the evidence is merely circumstantial at this point.

As of October 1, only one fatality has been associated with Enterovirus D68. The Rhode Island Department of Health reported that a 10-year-old child hospitalized with Enterovirus D68 died. Unfortunately, the child was also ill with bacterial sepsis, an infection of the bloodstream. Additionally, the CDC is reporting at least four people have died with complications from Enterovirus, however the details surrounding the exact causes of death have not been announced.

Although this is alarming, it’s important to remember that most children with Enterovirus D68 will recover without problems. However, children with asthma, diabetes, and other chronic health problems are at higher risk of serious complications from the virus. Parents should contact their pediatrician if their child is experiencing any significant respiratory issue. In my experience, I have seen several children who began wheezing with no prior history of requiring breathing treatments or having a diagnosis of asthma.

The uniqueness behind the recent outbreak of Enterovirus D68 is that a very large number of children have been affected within a few weeks. We would commonly expect this in the winter months with other viruses like influenza (the flu) or respiratory syncytial virus (RSV). It seems the August back-to-school rush created a perfect storm of person-to-person contact that spread the virus through the classrooms, hallways, and eventually across state lines. Unfortunately, viruses do not respond to antibiotics and there is no specific treatment other than supportive care like supplemental oxygen or IV fluids.

The CDC reports that 90 percent of the more than 100 children who died from seasonal flu last year were unvaccinated and reports have shown roughly half of the children who die from flu each year have no known risks for flu complications.

Get a flu vaccine for your child and for everyone in your family. Encourage frequent hand-washing, disinfect frequently touched surfaces (such as toys and doorknobs) and avoid kissing, hugging, and sharing cups or eating utensils with people who are sick. There’s no need for alarm unless your child develops difficulty breathing or symptoms seem to be worsening. If they do, seek medical attention as soon as possible.

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About Dr. Justin Morgan, Bundoo Pediatrician

Justin Morgan, MD, FAAP, is a board-certified pediatrician who practices general pediatrics in Louisville, Kentucky. He cares for children of all ages.

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