Enterovirus D68

The source for the information in this document is the Florida Department of Health.  For more information on EV-D68 and enteroviruses, please visit the Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/non-polio-enterovirus/outbreaks/EV-D68-outbreaks.html.

What is Enterovirus D68?
Enterovirus D68 (EV-D68) is one of more than 100 non-polio enteroviruses.  This virus was first identified in California in 1962.  The United States is currently experiencing a nationwide outbreak of Enterovirus D68 (EV-D68) associated with severe respiratory illness.  On October 6, 2014, the Florida Department of Health (FDOH) was notified of the first positive test for EV-D68 in a 10 year old Polk County resident.  The patient was initially hospitalized for respiratory illness, but has since recovered and is in good condition.

What are the symptoms of EV-D68?
EV-D68 can cause mild to severe respiratory illness.  Mild symptoms may include:

  • Fever
  • Runny nose
  • Sneezing
  • Cough
  • Body and muscle aches

Severe symptoms may include wheezing and difficulty breathing.  Anyone with respiratory illness should contact their primary care doctor, or if breathing becomes difficult or symptoms are getting worse seek medical attention.

How does EV-D68 spread?
EV-D68 causes respiratory illness.  The virus can be found in respiratory secretions of an infected person, such as saliva, nasal mucus or phlegm released through coughing.  EV-D68 is transmitted person-to-person when an infected person coughs, sneezes or has close contact with another person.  EV-D68 can also be spread through contact with a surface that has been touched by an infected person.  

How common is EV-D68 in Florida?
A mix of enteroviruses circulate every year and different types of enteroviruses can be common each year.  The last identification of EV-D68 in Florida was in 2009.

 Who is at risk for EV-D68?
Infants, children and teenagers are most likely to be infected with enteroviruses and become ill.  They do not yet have immunity (protection) resulting from previous exposures to these viruses.  Children with asthma or other chronic respiratory diseases may have a higher risk for severe illness caused by EV-D68 infection.  Adults may become infected with enteroviruses, however it is likely they will experience mild symptoms or no symptoms at all.

Children with asthma are at risk for severe symptoms from EV-D68 and other respiratory illnesses.  FDOH provides guidance and urges they maintain control of their illness during this time.

FDOH recommends:

  • Discuss and update your asthma action plan with your primary care provider.
  • Take your prescribed asthma medications as directed, especially long term control medication(s).
  • Be sure to keep your reliever medication with you.
  • Get a flu vaccine when available.
  • If you develop new or worsening asthma symptoms, follow the steps of your asthma action plan. If your symptoms do not go away, call your primary care provider right away.
  • Parents should make sure the child’s caregiver and/or teacher is aware of his/her condition, and that they know how to help if the child experiences any symptoms related to asthma.

How is EV-D68 diagnosed?
Specific lab tests on specimens from a person’s nose and throat are required to diagnose and confirm EV-D68 infections.  Many hospitals and some doctor’s offices can test ill patients to see if they have enterovirus infection.  However, the Florida Bureau of Public Health Laboratories are the only laboratories in Florida able to provide the specific testing to determine the type of enterovirus, like EV-D68.  FDOH recommends clinicians only consider EV-D68 testing for patients with severe respiratory illness and when the cause is unclear.

How is EV-D68 treated?
There are no specific treatments for people with respiratory illness caused by EV-D68.  For mild respiratory illness, you can help relieve symptoms by taking over-the-counter medications to reduce pain and fever.  Aspirin should not be given to children.  Some people with severe respiratory illness may need to be hospitalized.  Currently, there are no antiviral medications available for people who become infected with EV-D68.

How can I protect against EV-D68?
You can help prevent the spread of EV-D68 and other respiratory illnesses by following these steps:

  • Wash hands often with soap and water for 20 seconds.
  • Avoid touching eyes, nose and mouth with unwashed hands.
  • Avoid close contact such as kissing, hugging and sharing cups or eating utensils with people who are sick.
  • Cover your coughs and sneezes with a tissue or shirt sleeve, not your hands.
  • Clean and disinfect frequently touched surfaces, such as toys and doorknobs with a bleach solution, especially if someone is sick.  FDOH does not recommend the use of alcohol based cleaning tools as they are ineffective against EV-D68.
  • Stay home when you are sick.

There are no vaccines for preventing EV-D68 infections.

Additional Resources
For more information on EV-D68 and enteroviruses, please visit the Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/non-polio-enterovirus/outbreaks/EV-D68-outbreaks.html.