Recognizing and Preventing Enterovirus D68

November 7, 2014

Dr. Bradley Ornstein, Mercy Kids infectious disease and

rheumatology physician, addresses EV-D68.

ST. LOUIS - We’ve heard a lot about enterovirus infections this year. They are nothing new and are frequently seen during the summer and fall in the United States. Often, kids don’t show symptoms, but some illnesses with symptoms associated with enteroviruses include the common cold, sore throats and Hand-Foot-and-Mouth disease. Most of these infections cause a mild to moderate illness and rarely require hospitalization.

Over the last few months, 46 states - including Missouri - saw an increased number of children hospitalized with a severe respiratory illness caused by Enterovirus-D68 (EV-D68). There also has been suspicion, in rare instances, that EV-D68 has been the cause of neurologic symptoms similar to those seen with other enteroviruses such as polio. Though EV-D68 is not new, it has seldom - if ever - caused such widespread and severe illness as we have seen this year. And while the number of cases has been slowly tapering off, it’s still being seen in our community and across the country.

Children of all ages are bearing the brunt of this infection, likely because they haven’t had the chance to build immunity to this virus. While the vast majority of kids aren’t being hospitalized, those with underlying asthma seem to be at the greatest risk for developing more severe respiratory disease from EV-D68.  Symptoms typically include fever, runny nose, sneezing, cough and body aches; and, in the more severe cases, can include wheezing and difficulty breathing.

As the old adage goes, “an ounce of prevention is worth a pound of cure.” In that vein, the Centers for Disease Control and Prevention published these guidelines to help you and your family avoid catching or spreading EV-D68:

  • Wash hands often with soap and water for 20 seconds. Washing hands correctly is the most important thing you can do to stay healthy.
  • 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 - especially if someone is sick.
  • Stay home when you are sick and keep sick children out of school when they’re sick.

While we have no specific treatment for EV-D68, symptoms can be controlled with medications for fever and asthma.  Moreover, if your child has asthma, contact your doctor and make sure your asthma action plan is up- to-date and you have all prescribed medications available. If your child has difficulty breathing and you’re unable to control the symptoms, contact your doctor or seek medical attention at an urgent care location or emergency room.

Dr. Bradley Ornstein is a Mercy Kids pediatric rheumatologist and infectious disease physician with Mercy Children’s Hospital. For more information, please visit

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