Cold, Flu, & Cough Health Center

Enterovirus D68: What Parents Need to Know

Sept. 9, 2014 -- A fast-spreading virus related to hand, foot, and mouth disease is hospitalizing kids across the Midwest and parts of the South.

The virus, enterovirus D68, or EV-D68, was first discovered in 1962 in California. But until now, it has only been tied to smaller clusters of disease around the U.S.

This is the first time it’s caused such widespread misery, and it seems to be particularly hard on the lungs.

We reached out to pediatricians and infectious disease specialists to find out what parents should know about this respiratory illness.

What are the symptoms of D68 infection?

Most viral infections start out with a fever, cough, and runny nose, but D68 doesn’t seem to follow that classic pattern, says Mary Anne Jackson, MD. She's the division director of infectious disease at Children’s Mercy Hospital in Kansas City, MO, the hospital where the first cases were identified.

“Only 25% to 30% of our kids have fever, so the vast majority don’t,” Jackson says. Instead, kids with D68 infections have cough and trouble breathing, sometimes with wheezing.

They act like they have asthma, even if they don’t have a history of it, she says. “They’re just not moving air.”

Why so many cases now?

The typical enterovirus season runs from July through October, so we're in an enterovirus season, says Jackson.

What’s unusual about this one is that it’s a virus that hasn’t widely spread through the U.S. before.

“If you have a new virus that has not widely circulated, most people are going to be susceptible,” Jackson says.

The spreading of the virus coincided with the start of the new school year. Many hospitals noticed a big uptick in cases when kids went back to their classrooms.

Unfortunately, Jackson says, the outbreak may get worse before it gets better.

“In order for this virus to stop, it’s going to have to infect enough of the population to provide immunity and essentially burn itself out,” she says.

Who's at greatest risk?

Recent cases have been in children ages 6 months to 16 years, with most hovering around ages 4 and 5, the CDC says.

And while many kids are coming down with milder symptoms, the virus seems to be hitting children with a history of breathing problems particularly hard.

Two-thirds of those hospitalized at Children’s Mercy had a history of asthma or wheezing, Jackson says.

“We made sure that primary care providers are in touch with their patients with asthma, so those have an active asthma plan and know what to do if they get into trouble,” she says.

How is the infection treated?

Because it’s caused by a virus, and not bacteria, antibiotics don’t help.