Enterovirus D68 spreads in midwest United States

Clinicians should be aware that although the EV-D68 strain may present and behave similar to other enteroviruses, its clinical manifestations are unique.

EV-D68 spreads across midwestern United States
EV-D68 spreads across midwestern United States

Enterovirus D68 (EV-D68) has been pinpointed as the respiratory disease affecting children across the midwest United States.

“It's not much a surprise,” said Greg DeMuri, MD, who specializes in pediatric Infectious diseases at the University of Wisconsin, in an interview with The Clinical Advisor. “Enteroviruses usually occur in late summer and early fall.”

EV-D68, a member of the enterovirus family, more commonly effects children. The current epidemic coinciding with the start of the school year is no coincidence. “Children are more susceptible to enteroviruses because they haven't built up immunity,” explained DeMuri. EV-D68 is spread like other viral infections by coming into direct contact with people or things infected with the strain.

Although confirmed cases of the EV-D68 virus have been located primarily in the midwestern United States, DeMuri cautioned that the infection may be more widespread. “We tend to not test children for enteroviruses, so more cases may arise," said DeMuri.

“Most clinicians are very familiar with enteroviruses,” said DeMuri. Other enteroviruses include hand, foot, and mouth disease. The reported severity of EV-D68, however, has set it apart from other viruses.

Currently, there is no preventive treatment available to protect against the virus, and clinical treatment for infected patients is limited to supportive care.

How can clinicians differentiate between EV-D68 and other enteroviruses?

“Clinicians should be suspect when lower respiratory tract pathology occurs,” said DeMuri. Evidence of hypoxia, abnormal lung exam and chest x-ray should also be considered during diagnosis.

Enteroviruses are familiar in presentation, and their behavior is similar, but the clinical manifestations of the EVD-68 strain are unusual.

“We don't know the scope of the disease caused by this strain,” emphasized DeMuri. “There may be a wider spectrum [of cases].”



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