What Is the EV-D68 Virus? Everything You Need to Know to Keep Your Kids Safe

The Centers for Disease Control and Prevention (CDC) released a Health Alert Network (HAN) advisory notice on Sept. 9 regarding enterovirus D68 (EV-D68), a severe respiratory illness found primarily in children.

According to the CDC's release, healthcare providers and hospitals in several regions of the United States flagged to the CDC that in August, there were increases in pediatric hospitalizations in patients with severe respiratory illness who also tested positive for rhinovirus and/or enterovirus. With further testing, some patients were found to have EV-D68. This year, the rates of EV-D68 in children (who are already positive for rhinovirus and/or enterovirus) are higher than in previous years.

Why does it matter? While primarily a respiratory illness, EV-D68 "has been associated with acute flaccid myelitis (AFM), a rare but serious neurologic complication involving limb weakness," says the CDC.

The HAN health advisory's purpose is to inform healthcare providers, public health departments, labs, and specialists to consider EV-D68 when treating pediatric patients and be vigilant for potential case spikes in the upcoming weeks — but there are also considerations for the general public and parents.

Let's break down exactly what EV-D68 is, what to look out for, and how to keep your families safe.

What Are Rhinovirus (RV) and Enterovirus (EV)?

RVs and EVs are extremely similar in presentation and identical in treatment. To distinguish between the two — or identify a specific type of the viruses — requires a specific type of testing, including molecular sequencing. Both part of the Enterovirus genus — a family of viruses also including the common cold, aseptic meningitis, and polio — RVs and EVs are primarily seasonal viruses infecting approximately one billion people annually.

RVs are associated with the following, per the CDC:

  • Common cold symptoms
  • Acute respiratory illness (ARI)
  • Asthma exacerbation

EVs are associated with the following, per the CDC:

  • Common cold symptoms
  • Acute respiratory illness (ARI)
  • Febrile rash (the presence of a rash and fever)
  • Neurological illness (like aseptic meningitis or encephalitis, for example)
  • Acute flaccid myelitis (AFM)

What Is EV-D68?

Enterovirus D68 was first identified in California in 1962. Usually, EV-D68 causes mild respiratory illness (like a common cold) with no symptoms or mild symptoms. Sometimes it can develop into a more serious respiratory illness.

The CDC reports that only a small number of EV-D68 cases are reported regularly. But from August to November 2014, EV-D68 caused an outbreak of respiratory infections in the United States. As a result, "[the outbreak] raised awareness of EV-D68-associated illness and, beginning 2014, US surveillance for EV-D68 expanded. EV-D68 was subsequently detected in the US in the late summer and early fall of 2016, 2018 and, to a lesser degree, in 2020," reports the CDC.

Now the CDC is anticipating another potential spike in cases as fall begins (while you can get enteroviruses any time, you're more likely to get them seasonally in the summer and fall).

EV-D68 symptoms include:

  • Runny nose
  • Sneezing
  • Body or muscle aches
  • Coughing
  • Fever
  • Wheezing (severe symptom)
  • Difficulty breathing (severe symptom)

You also may have the EV-D68 virus and experience no symptoms at all. However, if you experience any symptoms, you should contact your doctor, particularly if you are having trouble breathing or experiencing worsening symptoms.

In rare cases, EV-D68 can cause acute flaccid myelitis (AFM), which is a serious medical condition. Symptoms include arm or leg weakness; drooping eyelids; difficulty moving the eyes; difficulty speaking or swallowing; facial weakness; and pain in the arms, back, neck, or legs. AFM can also cause paralysis, respiratory failure, and/or life-threatening changes in body temperature or blood pressure. If you or your child experience any of the above symptoms, seek immediate medical attention.

Is There Treatment For EV-D68?

Per the CDC, there are no vaccinations or specialized treatments for either RV or EV, and antibiotics aren't suitable for any viral infections, including respiratory infections. Medical care primarily focuses on supporting patients and alleviating symptoms.

Your best bet for protection is to take preventative measures to avoid infection in the first place. The CDC recommends the following:

  • Wash your hands thoroughly with soap and water for 20 seconds.
  • Avoid touching the face with unwashed hands.
  • Avoid close contact (including kissing, hugging, and sharing cups or utensils) with others who are sick or when you are sick.
  • Disinfect surfaces.
  • Cover your mouth and nose with a tissue or sleeve (not your hands) when you have to cough or sneeze.
  • For those with asthma, the CDC recommends keeping an updated asthma action plan.
  • Stay at home if you are sick.
  • Consider wearing a mask.
  • Stay up to date with all vaccinations.

Many of the preventative measures are simple lifestyle changes — but if you or your child are immunocompromised, you should work with your doctor for a prevention plan that feels right for you and your family.