What is Enterovirus D68?

Enterovirus D68 (EV-D68) is an infection caused by one kind of enterovirus. EV-D68 infections in the US are most common in late summer or early fall.

Enteroviruses are a common type of virus. Most adults don’t get EV-D68 because they were exposed to the virus in the past. They are immune, which means that their body can fight off another infection and they have mild or no symptoms at all. Children are more likely to get EV-D68 and have symptoms because they have not been exposed to the virus before, and are not immune.

What is the cause?

An enterovirus D68 infection is caused by a virus. When your child gets the virus, it is in mucus and saliva and can spread to others when your child coughs or sneezes. Other children can also get an infection if they touch something with the virus on it (like cups, doorknobs, and hands) and then touch their mouth, nose, or eyes.

What are the symptoms?

Symptoms may include:

• Fever
• Runny or stuffy nose
• Sneezing
• Coughing
• Muscle or body aches

Babies or children with asthma or other breathing problems may have more severe symptoms such as wheezing or trouble breathing.

In rare cases, some children have had severe weakness in their arms or legs after they had an EV-D68 infection. It is unknown if there is a connection between the D68 infection and the severe weakness.

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and medical history and examine your child. To test for the virus, your child may have:

• Blood tests
• Samples of fluid taken from your child’s nose or throat
• A lumbar puncture, also called a spinal tap, which uses a needle to get a sample of fluid from the area around the spinal cord. This is only done if your child has severe weakness.

How is it treated?

There is no specific treatment for EV-D68. Since it is caused by a virus, antibiotics do not help. However, there are some things you can do to help your child feel better:

• Make sure your child drinks a lot of clear liquids. Water, broth, juice, or an oral rehydration solution (ORS) such as Pedialyte are best. One way to tell if your child is drinking enough liquid is to look at the color of your child’s urine. It should be very light yellow.
• Give nonprescription medicine, such as acetaminophen, ibuprofen, or naproxen to treat pain and fever. Read the label carefully and give your child the correct dose as directed.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems.
  • Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome.
  • Acetaminophen may cause liver damage or other problems. Do not give more doses than directed. To make sure you don’t give your child too much, check other medicines your child takes to see if they also contain acetaminophen. Unless recommended by your healthcare provider, your child should not take this medicine for more than 5 days.
  • If your child has asthma, follow his asthma action plan. An asthma action plan is a written plan developed by your healthcare provider to help you manage your child’s asthma.

If your child has severe breathing problems or weakness, he may need to stay in the hospital. Your child may be given medicine and fluids by IV.

How can I take care of my child?

Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:

• How and when you will hear your child’s test results
• How long it will take to recover
• How to take care of your child when he goes home
• If there are activities your child should avoid and when he can return to normal activities
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

How can I prevent the spread of EV-D68?

There is no vaccine to prevent an EV-D68 infection. To reduce your child’s risk of getting or spreading the virus:

• Remind your child to wash his or her hands often and especially after using the restroom, coughing, sneezing, or blowing his nose. Also make sure he washes hands before eating or touching his eyes.
• Teach your child to cough and sneeze into a tissue or into the bend in his elbow. Throw away used tissues right away.
• Clean toys and surfaces that your child touches with soap and water. Then clean them again with a solution of 1 tablespoon of bleach mixed with 4 cups of water.
• Do not let your child share cups or eating utensils with others who are sick.
• Keep your child away from others who are sick. If your child is sick, do not let him go to school or daycare.

For more information, contact:

• Center for Disease Control and Prevention (CDC)
  800-232-4636
  http://www.cdc.gov