What Everyone Needs to Know About Enterovirus D68

Boy in hospital bed with respiratory illness. Rowan Allen/Cultura/Getty Images

Outbreaks of a particular type of respiratory illness - called enterovirus D68 (EV-D68) - have been reported in multiple states across the US starting in August 2014. These outbreaks have occurred mostly in children but have led to a significant increase in the number of hospitalizations for the time of year.

This relatively uncommon virus was actually first discovered in the 1960's but has been seen very rarely over the past several decades.

The new outbreak has parents and health care providers on edge.

What Is Enterovirus D68?

Enteroviruses are actually very common. There are over one hundred different types of enterovirus and they typically cause no or only mild symptoms and illnesses like the common cold. A few cause more serious problems like meningitis or encephalitis.

During the 2014 outbreak, enterovirus D68 caused primarily respiratory symptoms, which is unusual. The symptoms range from mild to severe and may include:

  • Wheezing
  • Difficulty breathing
  • Decreased blood oxygen levels
  • Fever
  • Sneezing or coughing
  • Body and muscle aches

At this point, most of the known cases are fairly significant because patients that have been tested and diagnosed with this particular virus have been hospitalized with their symptoms. The outbreak could actually be far more widespread than we know if more people have only mild symptoms and recover without treatment.

Like all enteroviruses, EV D68 is a virus - meaning antibiotics won't kill it. There are no antiviral medications that are effective against it and no vaccine to prevent it.

Not much else is known about this particular strain of enterovirus. Very few labs and hospitals have the capability to test for it, so most of the samples that have been identified have been sent to the CDC.

Who Is At Risk?

The outbreaks and illnesses that were reported in the fall and winter of 2014 were primarily in children. A majority of those who have been hardest hit have pre-existing conditions like asthma, which makes them more susceptible to serious illness when they get a respiratory infection. Although it can occur in anyone, young children under 5 and those with chronic respiratory conditions seem to be affected more than adults by this virus.

What Can I Do to Prevent It?

There is no vaccine or medication available to prevent EV-D68. Because it is a respiratory virus, it appears to be spread by close contact with infected people. The best way to protect yourself and your kids is by using good healthy hygiene practices. Teach your kids to wash their hands the right way, cover their cough and not share drinks or utensils.

If your child develops a respiratory illness that seems particularly severe or if he has a chronic illness like asthma, contact his health care provider to determine the best course of treatment.

Know the signs to watch for in a child to determine if she is having trouble breathing. They are much more subtle than most people realize and can progress from mild to severe very quickly.

Where We Stand

There was an unexplained outbreak of EV-D68 in 2014. From mid-August 2014 to mid-January 2015, 1,153 cases were confirmed in 49 states and the District of Columbia. CDC officials believe the actual number of cases were much higher - possibly in the millions - because those cases were less severe and patients did not seek treatment.

Health officials continue to work to study the virus, monitor outbreaks and develop treatments. Do your best to prevent the spread of illness by washing your hands, cleaning frequently touched surfaces with disinfectant and staying away from other people when you are sick.


"Respiratory Illness Due to Enterovirus D68 (EV-D68) in Missouri." Health Alert 29 Aug 14. Missouri Department of Health and Senior Services. 8 Sep 14.

Tadatsugu Imamura, Akira Suzuki, MD, PhD, Adam Meijer, PhD, Hubert G.M. Niesters, PhD, Janette C. Rahamat-Langendoen, MD, Jose Lojo, MPH, Richard L. Hodinka, PhD, Susan Coffin, MD, Stephen M. Ostroff, MD, Colleen S. Kraft, MD, John T. Redd, MD, Dean D. Erdman, DrPH, Xiaoyan Lu, Mark S. Oberste, PhD, Lauren J. Stockman, MPH, Gregory L. Armstrong, MD, Lara M. Jacobson, MD, Catherine Y. Yen, MD. "Clusters of Acute Respiratory Illness Associated With Human Enterovirus 68". Morbidity and Mortality Weekly Report. 2011;60(38):1301-1304. MedScape Multispecialty. 8 Sep 14.

"Severe Respiratory Illness Associated with Enterovirus D68 — Missouri and Illinois, 2014". Morbidity and Mortality Weekly Report (MMWR) 8 Sep 14. US Centers for Disease Control and Prevention. Department of Health and Human Services. 8 Sep 14.

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