5 Things You Need to Know About Enterovirus D68

After the recent death of a Michigan toddler and several new cases diagnosed in Southern California, Enterovirus D68, also known as EV-D68, continues to make headlines across the country.

The Centers for Disease Control and Prevention (CDC) reports that since mid-August 691 people in 46 states and the District of Columbia have contracted the virus. Almost all have been children who have a history with severe respiratory illness.

While those numbers sound high, they are not cause for alarm, says Dr. Jonathan Strober, a pediatric neurologist at UCSF Benioff Children's Hospital San Francisco. He explains that the CDC figure only includes people who were specifically tested for EV-D68, which is one of more than 100 known varieties of non-polio enteroviruses.

"There are likely many more cases of EV-D68 that came and went like a common cold," Strober says. He adds that it is unclear why there has been a higher than normal amount of EV-D68 cases reported this year, but it may be because doctors are testing for it more, so they are identifying it better.

To help quell your fears about EV-D68, here are five things you need to know about the virus.

1. It Acts Like a Common Cold

EV-D68 can cause mild to severe symptoms. Mild symptoms look a lot like the common cold which may include fever, running nose, cough, and body and muscle aches. These are the symptoms most children with EV-D68 display, Strober says. Severe symptoms are respiratory-related, including wheezing and difficulty breathing. In the last two months, these are the symptoms that have sent children to the hospital.

2. It Spreads Easily

EV-D68 is spread just like the common cold. That means frequent and thorough hand washing with soap and water for 20 seconds -- is one of the best ways to avoid the virus. Remind your children to avoid touching their eyes, nose and mouth with unwashed hands, and to cover coughs and sneezes with a tissue or shirt sleeve, not their hands. Clean and disinfect touched surfaces, like your child's toys, countertops and doorknobs. Strober recommends keeping your children away from kids who are sick, and keep them home from daycare or school if they are sick to avoid spreading the virus.

3. Some Children Are at Higher Risk

Infants, whose immune systems haven't fully matured, are at higher risk for the virus, as are the immune-suppressed. Children with a history of asthma or breathing problems seem to also have a higher susceptibility. If your child has asthma, make sure he or she is taking his or her medication as directed. EV-D68 can be confirmed from a nasal swab or stool sample, Strober says. Right now, only people with severe cases are being tested.

4. Most People Don't Need to Be Hospitalized

There are no specific medications to treat EV-D68. "Mild cases are treated just like a cold with rest and fluids," Strober says. You can also help relieve your child's symptoms by giving him or her over-the-counter medications for pain and fever. As with any virus, if you are not able to control your child's symptoms, or they are getting worse, call your doctor. If your child is having any concerning symptoms like weakness or trouble breathing, you should seek medical treatment immediately.

Note: Over the past several years, doctors have observed rare instances when patients, usually children, have quickly and sometimes permanently lost muscle function in an arm or leg or multiple limbs after experiencing symptoms of an upper-respiratory infection. Strober and other doctors are investigating whether these cases are related to EV-D68, but the link has not been confirmed.

5. The End is in Sight

While this year has had an exceptionally high number of reported cases of EV-D68, the CDC expects the numbers to taper off by late fall.

UCSF has set up a hotline for parents or caregivers of kids showing signs of muscle weakness possibly related to this illness. Call (415) 353-3857, or toll-free at (855) 487-7824, to reach the hotline.

Additional sources:


Reviewed by health care specialists at UCSF Benioff Children's Hospital.

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.

Related Information

UCSF Clinics & Centers

Child and Adolescent Neurology Clinic
1825 Fourth St., Fifth Floor, 5A
San Francisco, CA 94158
Phone: (415) 353-7596
Fax: (415) 353-2400