Respiratory Illness Surge Due to Enterovirus D68

I have been seeing a large number of respiratory infections in my office over the last 3 weeks. These appear to be viral infections cause by Enterovirus D68 and have some significant respiratory consequences, especially in children with other lung problems.

Enterovirus Electron Micrograph

Enterovirus Electron Micrograph

EV-D68 is one of more than 100 types of enteroviruses. It was first identified in California in 1962. Since then, EV-D68 infections has not been commonly reported in the United States. There have been very few reports of this virus in the last few years, however, the circulation of specific types of enteroviruses is often quite unpredictable, and different types of enteroviruses can be common in different years with no particular pattern. Most enterovirus infections in the United States tend to occur in the summer and fall. EV-D68, similar to other enteroviruses, is known to cause infections primarily in children but has been known to infect adults.

EV-D68 can shed from an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum. The virus likely spreads from person to person when an infected person coughs, sneezes, or touches another surface. EV-D68 can cause mild to severe respiratory illness. Most of the children who have become very ill with EV-D68 infection in Missouri and Illinois had difficulty breathing, and some had wheezing. Many of these children had asthma or a history of wheezing.

Although there are no vaccines to prevent EV-D68 infections, clinicians should encourage their patients to follow these prevention steps:

Wash hands often with soap and water for 20 seconds;

Avoid touching eyes, nose, and mouth with unwashed hands;

Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick; and

Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.

Enterovirus SymptomsEnsure that patients with asthma regularly take prescribed medications and follow guidance to maintain control of their illness. They should also take advantage of influenza vaccine when available, because people with asthma have a difficult time with respiratory illnesses.

Hopefully, you and your family won’t have a problem with this virus this year. Follow the steps above to help prevent its spread and see your doctor if you begin to show signs of serious illness like fever, shortness of breath, persisting cough or worsening flu-like illness that is not improving.

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