Enterovirus D68 (EV 68)

Enterovirus D68 (EV 68) is one of a large group of over 100 enteroviruses that can cause respiratory illness, diarrhea, rash and even meningitis and encephalitis.  This particular virus was first identified in California in 1962.  It has been circulating worldwide for several years, causing mild to severe respiratory illness.

What are the symptoms of EV 68?

EV 68 can cause mild to severe respiratory illness.

• Mild symptoms may include fever, runny nose, sneezing, cough, and body and muscle aches.
• Some children that get EV 68 infection may have wheezing and difficulty breathing.  Most of these children have asthma or a history of wheezing.

How does EV 68 spread?

Since EV 68 causes respiratory illness, the virus can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum.  EV 68 likely spreads from person to person when an infected person coughs, sneezes or touches surfaces and contaminates them with the virus.

Who is at risk?

In general, infants, children, and teenagers are most likely to get infected with enteroviruses.  That's because they do not yet have immunity (protection) from previous exposures to these viruses.  This appears to be true for EV 68.  Among the EV 68 cases identified during August and September 2014, children with asthma had a higher risk for severe respiratory illness.

How is EV 68 treated?

There is no specific treatment for people with respiratory illness caused by EV 68.

• For mild respiratory illness, symptoms can be relieved by taking over-the-counter medications for pain and fever. Aspirin should not be given to children under 19.
• People with severe respiratory illness should be seen by a healthcare provider and may need hospitalization.
• There are no antiviral medications available for people who become infected with EV 68.

Is there a vaccine for EV 68?

No. There is no vaccine.

How is EV 68 diagnosed?

EV 68 can only be diagnosed by doing specific lab tests.

In general, respiratory illnesses can be caused by many different viruses and have similar symptoms.  Not all respiratory illnesses which occur are due to EV 68.  Anyone with respiratory illness should contact their doctor if they are having difficulty breathing or if their symptoms are getting worse.

How can you protect yourself and your family from EV 68?

You can help protect yourself from respiratory illnesses by following these steps:

• Wash hands often with soap and water for 20 seconds, especially after changing diapers.
• Avoid touching your eyes, nose and mouth with unwashed hands.
• Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick.
• Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
• In schools and daycares, routine environmental cleaning and sanitation is required, especially of high-touch surfaces.

Since people with asthma are at higher risk for respiratory illnesses, they should take the asthma medications prescribed for them in order to maintain control of their asthma.  They should seek care early if they are experiencing respiratory symptoms.  In addition, they should be sure to get vaccinated for the flu since people with asthma are at an increased risk of complications from the flu virus.

Can a child with a respiratory illness attend school?

In general, children who are ill should be kept out of school until their symptoms improve. 

Children with chronic cough and/or reactive airway disease should return to school when they are well enough to return.

• Your doctor, nurse or clinic, or your local board of health (listed in the phone book under local government).
• The Massachusetts Department of Public Health (MDPH), Division of Epidemiology and Immunization at (617) 983-6800 or on the MDPH Website.
• The Centers for Disease Control and Prevention (CDC) website.