• Enterovirus D68 Infection

    (EV-D68 Infection)

    Definition

    Enterovirus D68 (EV-D68) is a virus that can cause mild to severe infections of the lungs and breathing passages.
    Virus
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    Causes

    EV-D68 passes from person to person through infected fluids of the mouth and nose. When an infected person coughs or sneezes the virus becomes airborne. A nearby healthy person may then inhale the virus. The virus can also exist on a surface once it has been touched by an infected person. The virus can then be transferred when a healthy person touches that surface and then touches their mouth or nose. Not all people who come in contact with the virus will develop an infection.

    Risk Factors

    Infants are at increased risk of infection because their immune system has not fully developed. Children and teenagers are at increased risk due to high rate of exposure, poor use of preventive hygiene methods, and a lack of previous exposure that would protect from the virus.
    Factors that may increase a child’s risk of a respiratory infection include:
    Asthma
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    Symptoms

    Mild symptoms are similar to a common cold and include:
    • Fever
    • Runny nose
    • Sneezing
    • Cough
    • Muscle aches
    More severe symptoms may include:
    • Wheezing
    • Difficulty breathing

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.
    Your bodily fluids may be tested if there is a severe or long lasting infection. Evidence of EV-D68 may be found with:

    Treatment

    Talk with your doctor about the best treatment plan for you. Options include:

    Mild Infections

    Mild infections do not need special treatment. The goal is to ease the symptoms while the body fights the virus. Antibiotics are not useful, unless there is bacterial infection due to the illness, because antibiotics not effective against viruses.
    Home care steps can help to relieve symptoms. Steps may include:
    • Drinking plenty of liquids, to help keep nasal fluid thin and easy to clear.
    • Cool-mist vaporizer to humidify the air to help reduce coughing and sooth irritated breathing passages.
    • Salt-water nose drops to loosen mucus in the nose.
    • Over-the-counter medication to reduce pain and fever.
    Note: Aspirin is not recommended for children with a current or recent viral infection. Check with the doctor before giving your child aspirin.

    Severe Infections

    Severe infections cause breathing problems and wheezing. They may require treatment in a hospital. The treatment is aimed at opening up breathing passages and sometimes supporting breathing with oxygen. Treatment may include:
    • Humidified air
    • Supplemental oxygen
    • Medications to improve breathing
    • In certain cases, mechanical ventilation may be used if you or your child is unable to breathe without assistance

    Prevention

    There is no vaccine available for EV-D68. To help reduce your chance of getting any respiratory infection:
    • Wash your hands often. This is especially important after touching someone who may have a cold or other infection.
    • Avoid touching your face and rubbing your eyes.
    • Do not share items such as cups, glasses, silverware, or towels with people who may have a cold or other infection.
    • Disinfect frequently-used surfaces, such as counters and doorknobs.
    • Manage asthma or wheezing conditions as advised by your doctor. This may include getting an influenza vaccine.

    RESOURCES

    Centers for Disease Control and Prevention http://www.cdc.gov

    American Academy of Allergy Asthma & Immunology http://www.aaaai.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Public Health Agency of Canada http://www.phac-aspc.gc.ca

    References

    Enterovirus D68. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/non-polio-enterovirus/about/ev-d68.html. Updated September 25, 2014. Accessed October 1, 2014.

    Enterovirus D68 infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T905971/Enterovirus-D68-infection. Updated July 28, 2016. Accessed October 3, 2016.

    Enteroviruses. Oklahoma State Department of Health website. Available at: http://www.ok.gov/health/Disease,%5FPrevention,%5FPreparedness/Acute%5FDisease%5FService/Disease%5FInformation/Enterovirus.html. Accessed October 1, 2014.

    Enteroviruses and enterovirus D68. Washington State Department of Health website. Available at: http://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/EnterovirusD68. Accessed October 1, 2014.

    Midgley CM, Jackson MA, Selvarangan R, et al. Severe respiratory illness associated with enterovirus D68—Missouri and Illinois, 2014. MMWR Morb Mortal Wkly Rep. 2014;63(36):798-799.

    Revision Information

    • Reviewer: EBSCO Medical Review Board David L. Horn, MD
    • Review Date: 03/2017
    • Update Date: 10/03/2016
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