enterovirusEnterovirus D68 (also known as EV-D68) is in the news as it has now affected children in forty-four states. Parents want to know what it is – and what they can do to help prevent infection in their own children.

We’re here to answer your questions.

First off, what is enterovirus?

Enteroviruses are a family of more than 100 viruses that are typically found within the gastrointestinal tract. Most of these viruses tend to cause mild diseases with symptoms including abdominal discomfort, loose stools, rashes, sore throat, and cold-like symptoms. Enterovirus D68 (EV-D68) has circulated in North America in the past; however, it has been an uncommon cause of enteroviral infection.

Why is this year – and this strain of enterovirus – different?

Each fall,in temperate North America, we see a surge in the number of infections due to enteroviruses. This year is a bit different: many state health departments and hospitals are reporting a larger than expected number of children with severe respiratory illness. This increase could be caused by many different viruses that are common during this time of year. However, EV-D68 appears to be the predominant type of enterovirus this year and seems to be the major contributor to the increase in respiratory illnesses.

EV-D68 can cause upper as well as lower respiratory tract disease. The disease is characterized by body aches, runny nose, cough, and shortness of breath. Fever is not a predominant sign. The disease can be mild but in some children, particularly those with a history of asthma or wheezing, the disease can be quite severe – even requiring hospitalization.

As of October 7, 2014, forty-four states, including Vermont, have confirmed respiratory illness in children due to EV-D68. While Vermont children have been diagnosed with EV-D68, we have not seen a surge in hospitalizations due to respiratory illness. Although EV-D68 has garnered national attention, the vast majority of children infected with the virus will not require hospitalization or any care other than rest and supportive measures at home.

What are the signs and symptoms of Enterovirus D-68?

In many, infection with EV-D68 will look like a typical common cold and can be managed as such. Symptoms may include runny nose, sneezing, cough, and body and muscle aches. A severe symptom is difficulty breathing, Parents should watch for children who are breathing faster or harder than usual. These children should see their health care provider. The health care provider may not test for EV-D68 as there is no specific treatment for the infection.

How does Enterovirus D68 spread?

EV-D68 spreads from person to person when an infected person coughs, sneezes, or touches a surface that is then touched by others. The virus can be found in respiratory secretions including saliva, nasal mucus, or sputum.

How do I protect myself and my children from EV-D68?

While there is no vaccine to prevent EV-D68, simple measures to protect yourself and others from infection include the following:

  1. Wash hands often with soap and water for 20 seconds.
  2. Make sure to cover your nose with tissue when coughing or sneezing.
  3. Avoid touching mouth/nose/eyes with unwashed hands.
  4. Avoid kissing, hugging, and sharing cups and utensils with people who are sick.
  5. Children who are exhibiting symptoms should be kept home from school.

For more information visit the Centers for Disease Control and Prevention website.

Meredith Bryden is a fourth-year medical student at the Larner College of Medicine at UVM. She is currently applying to residency in pediatrics. 

William Raszka, MD, is a pediatric infectious disease specialist at the University of Vermont Children’s Hospital at the University of Vermont Medical Center and a professor at the Larner College of Medicine at UVM. 

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