Summary about Disease
Enterovirus D68 (EV-D68) is a non-polio enterovirus that can cause mild to severe respiratory illness. While many people infected with EV-D68 experience mild symptoms similar to a common cold, in some cases, particularly in children, it can lead to more serious complications, including neurological issues like acute flaccid myelitis (AFM). The virus is most common in late summer and fall.
Symptoms
Symptoms of EV-D68 can range from mild to severe. Mild symptoms may include:
Fever
Runny nose
Sneezing
Cough
Body aches
Muscle aches More severe symptoms may include:
Wheezing
Difficulty breathing
Neurological symptoms (in rare cases): limb weakness, facial droop, difficulty speaking or swallowing (signs of AFM)
Causes
EV-D68 is caused by infection with the Enterovirus D68 virus. The virus spreads through:
Respiratory droplets produced when an infected person coughs or sneezes
Touching surfaces contaminated with the virus and then touching the face (eyes, nose, or mouth)
Close contact with an infected person
Medicine Used
4. Medicine used There is no specific antiviral treatment for EV-D68. Treatment focuses on managing symptoms. This may include:
Over-the-counter pain relievers (like acetaminophen or ibuprofen) for fever and body aches
Decongestants and saline nasal spray for congestion
Bronchodilators (inhalers) for wheezing and difficulty breathing (for those with asthma or reactive airway disease)
Supportive care, such as oxygen or ventilation, in severe cases
For AFM, treatments might include intravenous immunoglobulin (IVIG), steroids, or plasma exchange, along with physical and occupational therapy. The benefit of these treatments are uncertain.
Is Communicable
Yes, EV-D68 is highly communicable. It spreads easily through respiratory droplets, close contact, and contaminated surfaces.
Precautions
To prevent the spread of EV-D68:
Wash hands frequently with soap and water for at least 20 seconds, especially after coughing, sneezing, or being in public places.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Cover your coughs and sneezes with a tissue or your elbow.
Stay home if you are sick.
Clean and disinfect frequently touched surfaces.
Avoid close contact with people who are sick.
How long does an outbreak last?
EV-D68 outbreaks typically occur in late summer and fall. The duration of an outbreak can vary, but they usually subside with the onset of colder weather and the decline in other respiratory viruses. The peak of an outbreak may last for several weeks to a few months.
How is it diagnosed?
EV-D68 is diagnosed through laboratory testing of respiratory specimens (nasal swabs, throat swabs). A real-time reverse transcription polymerase chain reaction (RT-PCR) assay is used to detect the virus. Because many enteroviruses cause similar symptoms, specific testing is needed to confirm EV-D68. Clinical diagnosis based on symptoms alone is difficult.
Timeline of Symptoms
9. Timeline of symptoms The incubation period (time from exposure to symptoms) for EV-D68 is typically 3 to 10 days.
Days 1-3: Mild cold-like symptoms may appear, such as fever, runny nose, sneezing, and cough.
Days 3-7: Symptoms may worsen, including increased coughing, wheezing, and difficulty breathing (especially in individuals with asthma).
Days 7+: Most people will begin to recover. However, in rare cases, neurological symptoms (AFM) may appear days or weeks after the respiratory illness.
Important Considerations
Individuals with asthma or other respiratory conditions are at higher risk for severe illness from EV-D68.
Although rare, the association between EV-D68 and AFM is a significant concern, particularly in children. Any new onset of limb weakness or neurological symptoms should be evaluated by a healthcare professional immediately.
There is no vaccine for EV-D68.
Public health monitoring and surveillance are essential to track the spread of EV-D68 and implement preventive measures.