Recently, a mild-to-severe respiratory illness in children in the Southeast and Midwest United States has been emerging. The US Centers for Disease Control and Prevention (CDC) report that between mid-August and September 11th, 2014, their laboratory has confirmed 82 cases in six states of Enterovirus-D68 (1). This figure doesn’t include non-confirmed cases and cases tested outside of the CDC laboratory; the true number of cases is certainly higher, with hundreds of children reportedly showing symptoms.
What is Enterovirus-D68?
The culprit of this outbreak, Enterovirus-D68 or EV-D68, is a rare member of the non-polio enterovirus family. According to the CDC, it was first reported in California in 1962, but has rarely been seen in the United States since (1).
What are the symptoms of EV-D68 infection?
EV-D68 causes respiratory illness. At the mildest, the virus acts like the common cold, causing coughing, sneezing, and a runny nose. It may act like the flu, causing fever, and muscle and body aches.
A main concern is for children with a history of asthma or wheezing. These children are prone to more severe cases of EV-D68, which involves difficulty breathing and wheezing.
Mark Pallansch, director of the CDC’s Division of Viral Diseases, stated that the number of hospitalizations reported could be “just the tip of the iceberg in terms of severe cases” (2).
Why are there so many hospitalizations?
The plain answer: we don’t know. Public health is a challenging field, where scientists and doctors have to act quickly and in real time as outbreaks unfold. Enteroviruses typically do spread amongst children at this time of year – but they tend to cause simple colds rather than surges in hospitalizations. The CDC is working hard to unravel the source of the current outbreak.
Earlier this year, we reported on an outbreak of another enterovirus, EV-68, among children in California. EV-68 was incredibly rare, but caused polio-like symptoms including muscle paralysis. Could the causes of the two outbreaks be related?
Should I be worried?
EV-D68 has been reported in Alabama, Colorado, Michigan, Georgia, Ohio, Iowa, Illinois, Missouri, Kansas, Oklahoma, North Carolina, Kentucky, and Utah (3,4). If you live in or near these areas and have children, keep an eye out for symptoms, especially if your child has asthma or a history of wheezing.
It is recommended that you take your child to the doctor if he or she develops a rash, fever, or has difficulty breathing (2). Fortunately, most cases will be self-limiting, and will only require treatment for symptoms.
How do I prevent EV-D68?
The CDC has provided a useful infographic, below:
- Centers for Disease Control and Prevention. Non-polio enterovirus: Enterovirus D68. http://www.cdc.gov/non-polio-enterovirus/about/EV-D68.html (accessed 12 September 2014).
- Martinez M, Newsome J, Cohen E, Dyerm K, Hughes T, Biery-Colick K. 10 states report outbreak of respiratory illness in kids. USA Today [Internet]. http://www.usatoday.com/story/news/nation-now/2014/09/08/respiratory-virus-midwest-children/15269751/ (accessed 12 September 2014).
- Wilson J. What parents should know about EV-D68. CNN [Internet]. http://www.cnn.com/2014/09/08/health/enterovirus-d68-symptoms/index.html (accessed 12 September 2014).
- Shankar S. Enterovirus EV-D68, causing respiratory infection in children, reported in 10 US states. International Business Times [Internet]. http://www.cnn.com/2014/09/08/health/enterovirus-d68-symptoms/index.html (accessed 12 September 2014).