Aileen M. Marty, M.D.

Director, FIU Health Travel Medicine Program

So far Florida has been spared. We are only one of seven states not yet affected by the deadly countrywide enterovirus outbreak. From mid-August to October 6, 2014, the Centers for Disease Control and Prevention or state public health laboratories have confirmed 594 cases from 43 states and the District of Columbia, including four deaths. Human Enterovirus 68 (EV-D68) has been a rarely reported virus that can cause respiratory disease. Over 80% of those sick with EV-D68 have been children. Severe cases are more common among children with underlying respiratory problems such as asthma or a history of wheezing.

What is EV-D68?

Enteroviruses are among the most common disease causing germs; and can produce a wide range of clinical manifestations, ranging from mild febrile illness to fatal meningitis and encephalitis. We first recognized EV-D68 in 1962 when it was isolated from the blood of four children in California who had symptoms of pneumonia and bronchiolitis. While there were sporadic cases in various places, it was really only about five years ago that hospitals in many parts of the world began seeing more and more instances of children and others with symptoms caused by EV-D68.

Symptoms

• Mild symptoms may include fever, runny nose, sneezing, cough, and body and muscle aches.
• Severe symptoms may include wheezing and difficulty breathing, paralysis.

Although in serious cases, this disease can cause paralysis, even death; there are likely many children affected with milder forms of illness, who never seek medical attention at a doctor’s office or hospital and may go undetected.

Health Care workers should consider EV-D68 as a possible cause of any acute, unexplained severe respiratory illness, even if the person does not have fever and especially if the child has a history of asthma or other underlying respiratory disease.

Treatment

There is no specific treatment. Antiviral drugs that work well against other enteroviruses do not appear to work in individuals with EV-D68.  There are no vaccines to prevent EV-D68 infection. 

Prevention

This disease spreads when an infected person coughs, sneezes, or touches contaminated surfaces. 

• Hand hygiene and social distancing reduces the spread of this and many other viral and non-viral contagious diseases. Washing hands for at least 30 seconds with soap and water is recommended; remember to wash each finger individually.
• Avoid touching eyes, nose, and mouth with unwashed hands.
•  Avoid kissing and sharing eating utensils with people who are sick.
•  Disinfect any frequently touched surfaces, especially if someone in the home or workplace is sick.
• If you have asthma be sure to have an asthma action plan devised between you and your doctor.
• Take advantage of the vaccines that are available such as Influenza vaccine to reduce your risk of having an underlying respiratory illness.