BACKGROUNDER: What you need to know about enterovirus D68

Enterovirus D68 was first identified in four people in California in 1962.

There have been at least six outbreaks of EV-D68 since 2008, and past ones have started in the fall.

In mid-August of this year, the U.S. Centers for Disease Control and Prevention (CDC) began investigating clusters of children with severe respiratory illness in the American Midwest. Lab tests confirmed EV-D68 was the cause.

The CDC has since reported an increasing number of laboratory-confirmed cases of EV-D68 from other states.

As of Oct. 2, 514 people in 43 states and the District of Columbia had tested positive for EV-D68. Four American children who had the virus have died, but it’s not clear if other illnesses were the cause.

There have been dozens of confirmed cases of EV-D68 in western and central Canada. A small number of infected children have developed polio-like symptoms, including one in Hamilton and two in British Columbia.

The actual number of cases of EV-D68 is not known as people with viral infections often don’t seek medical care and swabs to test for viral infections are not routinely done.

Below is a backgrounder on the virus.

What is enterovirus D68?

Enteroviruses are a group of viruses. There are about 100 enteroviruses that can cause a range of symptoms from no symptoms at all, to mild cold-like symptoms, to illnesses with fever and rashes, to neurologic problems.

EV-D68 is a specific enterovirus that causes mild to severe respiratory illness. Symptoms can include a cold-like illness with coughing and wheezing to severe infections requiring hospitalization or possibly to an intensive care unit because of breathing difficulties.

Children and teenagers appear to be at increased risk of getting EV-D68 because they haven’t been exposed to the virus and therefore have not built up immunity. The virus can infect adults as well.

How do you get the virus?

EV-D68 can be present in the nose and throat and spread from one infected person to another when he or she coughs or sneezes. Touching objects or surfaces contaminated with these respiratory secretions may also result in infection if the virus then gets into the body via the mouth, nose or eyes.

How is the infection treated?

There is no vaccine or specific antiviral treatment for EV-D68.

Most people don’t require any treatment and will get better on their own, but symptoms like wheezing and fever can be treated. Aspirin should be avoided in children.

Patients who have difficulty breathing may require hospitalization and those with severe breathing problems may require treatment in an intensive care unit including being placed on a ventilator.

What precautions can you take to prevent transmission?

  • Clean your hands frequently with soap and water or hand sanitizer, including after touching commonly touched objects and surfaces, before touching your face, before preparing food and before eating;
  • Avoid touching your face as much as possible;
  • Stay at least two metres away from people who are ill;
  • Frequently clean surfaces and objects that are commonly touched.

To avoid spreading viral infections:

  • Stay home from work, school and other activities if you are ill;
  • Cough and sneeze into your elbow and not your hand;
  • Wash your hands frequently with soap and water or hand sanitizer.

Compiled from Public Health Ontario, U.S. Center for Disease Control and Prevention and Public Health Agency of Canada and National Collaborating Centre for Infectious Diseases

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