Enterovirus D68: A Q&A with Michael Smit, MD

December 1, 2014
Michael Smit, MD, an infectious diseases specialist at Hasbro Children’s Hospital, talks about enterovirus D68, what it is, what the symptoms are and how to prevent it.

Enterovirus D68 (EV-D68) began garnering national headlines in August when states in the Midwest saw a surge in cases of this respiratory disease, which can cause severe breathing problems in children. With schools back in session, the disease is being spread more easily. Michael Smit, MD, a pediatric infectious diseases specialist with Hasbro Children’s Hospital answers questions about D68 and what parents should know.

To stop the spread of enteroviruses and other seasonal illness, such as flu, everyone should:

  • Wash hands often, and with soap and water for 20 seconds, especially after using the bathroom, changing diapers, coughing or sneezing, and before eating or preparing food.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid kissing or hugging people who are sick, or when you are sick.
  • Avoid sharing dishes or eating utensils with people who are sick, or when sick.
  • Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
  • Cover your cough; Cough into your elbows—not your hands.
  • Discard used tissues right away.

What is Enterovirus D68 and why should parents be concerned?

EV-D68 is one of many non-polio enteroviruses. It is closely related to rhinovirus, which causes the common cold. This virus was first identified in California in 1962, but it has not been commonly reported in the United States. Identification of a large number of patients with EV-D68 respiratory disease detected during a single season is a recent development.

This virus is of concern now because it can cause more severe disease than the usual common cold. In some pediatric hospitals up to 15 percent of the patients admitted with EV-D68 infection had to receive care in the intensive care unit.

What are the signs and symptoms? How is it different from the common cold?

Most enterovirus infections cause no or very mild symptoms. When an enterovirus does cause disease, signs and symptoms vary widely and can include mild cough and runny nose, fever and rash, and neurologic illness, such as aseptic meningitis and encephalitis.

In contrast, EV-D68 has been associated almost exclusively with respiratory disease. EV-D68 can cause more severe disease than the usual common cold. Children have presented with difficulty breathing and sometimes with wheezing. As of this time, it appears that a minority of those infected with EV-D68 have fever when they present to a hospital for care. Symptoms have ranged from very mild runny nose and cough to severe breathing difficulty requiring admission to the intensive care unit.

What should parents do if their child starts to exhibit those symptoms?

There is no specific treatment or vaccine for EV-D68. If your child has milder symptoms, you can contact your pediatrician for advice. For mild illness, you can help relieve symptoms by taking over-the-counter medications if needed. Remember that aspirin should not be given to children.

If your child experiences any difficulty in breathing, with or without fever or wheezing, seek immediate medical care.

What can be done to prevent infection?

Wash your hands frequently with soap and water for at least 20 seconds.

If you have symptoms suggestive of a respiratory infection, stay at home. If your children are sick, do not send them to school.

Learn more about Enterovirus D68 (CDC.gov)