The Centers for Disease Control and Prevention (CDC) issued a advisory after an increase in hospitalizations among children due to severe respiratory illnesses, including EV-D68, since July. While most historical cases have been limited to the United States, infections have previously spread to Europe. The enterovirus D68, first recorded in California in 1962 and originally considered rare, has seen a rise in cases since 2001. According to CDC experts, most EV-D68 cases do not cause any symptoms, or only mild symptoms such as aches, cough, and runny nose. Fever was reported in about half of all cases. However, in rare cases, the virus is believed to affect the spinal cord, leading to muscle weakness and sometimes paralysis in a condition known as "acute flaccid myelitis." While it is thought this condition has various other causes, 90% of known cases have been observed in young children.
The CDC explained that enterovirus D68 spreads "when an infected person coughs or sneezes or touches a surface used by others afterward." They added, "Generally, infants, children, and teenagers are most susceptible to enteroviruses and illness. This is because they do not yet have immunity from previous exposures to these viruses. Adults can become infected with enteroviruses, but they are less likely to show symptoms or only mild symptoms."
The CDC advised doctors in the United States to consider EV-D68 as a potential cause when any child is diagnosed with severe respiratory illness, with or without fever. Meanwhile, the public has been encouraged to take basic precautions to protect against EV-D68 and other respiratory viruses. This includes regularly washing hands, covering coughs and sneezes with a tissue, avoiding close contact with sick individuals, and staying home when feeling unwell. There are currently no vaccines available to protect against EV-D68; however, staying informed about COVID boosters and flu vaccines can help prevent complications from viral illnesses.
Experts added that children with severe symptoms such as shortness of breath and difficulty breathing should receive medical attention as soon as possible. The CDC warned that children with asthma are at higher risk of severe illness when infected with enterovirus D68. Tracking the spread of EV-D68 is challenging since the majority of hospitals and doctors' offices in the United States do not conduct the necessary testing to diagnose a specific enterovirus strain.
Nevertheless, the CDC recommended that healthcare providers in the United States remain "vigilant and report possible cases of acute flaccid myelitis to the state or local health departments." While historical cases of EV-D68 have primarily been confined to the United States, outbreaks have been recognized elsewhere. As the UK Health Security Agency outlines: "In August 2014, the USA and Canada reported an increase in detections of EV-D68 associated with severe respiratory illness and unexplained neurological disease cases. In response, British and European surveillance for EV-D68 was enhanced, and in 2014 and 2015, 56 and 14 cases were identified respectively in the UK." They added that in 2018, "68 laboratory-confirmed cases of EV-D68 were diagnosed by national reference laboratories in England and Wales."
