What Is EV-D68? Enterovirus D68 Causes & Symptoms
You’re probably familiar with enteroviruses, even if you don’t recognize them by that name. That’s because enteroviruses are responsible for causing childhood illnesses like hand, foot and mouth disease, meningitis and polio.
Recently, one type of non-polio enterovirus has been on the rise — the enterovirus D68, or EV-D68. About 10 to 15 million EV-D68 infections occur every year in the United States, according to the American Academy of Pediatrics (AAP), and while most of them trigger little to no symptoms, the virus can, on very rare occasions, cause serious breathing problems in children.
Although you may be hearing more about EV-D68 in the news, it’s important to remember that the virus itself is common and “very, very rarely causes serious side effects,” says Micah Resnick, M.D., a board-certified pediatrician in Cincinnati, Ohio, and member of the What to Expect Medical Review Board.
“We see this alert every couple years,” Dr. Resnick says. “This is not something new, it is just something that health professionals and family should be cognizant of. But you do not have to have an increase in fear.”
What is EV-D68?
EV-D68 is a type of non-polio enterovirus that’s primarily spread through an infected person’s saliva or mucus, usually when someone coughs, sneezes or transfers the germs onto a surface. Although the virus can circulate year-round, most people in the U.S. catch it in the summer and fall.
While EV-D68 was first discovered in 1962, the virus never caused an outbreak in the U.S. until the later summer and fall of 2014, according to the Centers for Disease Control and Prevention (CDC). Since then, cases have been detected in 2016, 2018, 2020 and 2022.
Most people will only experience mild symptoms from EV-D68, if any, according to the CDC. In very rare cases, the virus can trigger a condition in children called acute flaccid myelitis (AFM), which causes muscle weakness.
What are the symptoms of enterovirus D68?
Some people who have EV-D68 won’t experience any symptoms at all. The symptoms that do appear, however, are similar to those of the common cold. They typically include:
- Runny nose
- Body and muscle aches
- Wheezing and difficulty breathing (in more severe cases)
Very rarely, EV-D68 can also lead to AFM, which can cause:
- Arm or leg weakness
- Loss of muscle tone and reflexes
- Difficulty moving the eyes or drooping eyelids
- Facial drooping or weakness
- Difficulty swallowing
- Slurred speech
- Pain in the arms, legs, neck or back
- Numbness or tingling in the arms or legs (though this symptom is rare)
Keep in mind that AFM is very rare: “So far this year there have been 14 confirmed cases of acute flaccid myelitis, so that’s about a one in 1 million chance of your child developing this severe and potentially fatal complication,” says Dr. Resnick.
It’s thought that infants, children and teenagers are most likely to catch EV-D68 because they lack immunity to the virus, in part because they haven’t been exposed to enteroviruses in the past, according to the CDC.
Children who have asthma can also experience more severe respiratory symptoms from EV-D68.
Should parents be concerned about EV-D68 and the risk of paralysis?
“Muscle weakness from EV-D68 isn’t very common, so there’s no need to worry with every cold,” says Gina Posner, M.D., a pediatrician with MemorialCare Medical Group in Fountain Valley, California, and a member of the What to Expect Medical Review Board.
In most children, the virus will only trigger cold-like symptoms, but kids with asthma may experience more serious complications, like trouble breathing. If your child has asthma, keep their inhaler or nebulizer on hand and make sure they’re taking any medications they’ve been prescribed.
The virus also doesn’t appear to cause complications during pregnancy.
How parents can protect their children
There’s no specific treatment (or vaccine) for EV-D68, so your best bet is to protect your child from getting the virus. Here are a few strategies that can help keep little ones healthy from viruses in general:
- Make sure your child washes her hands regularly with soap and water for at least 20 seconds.
- Remind your child not to touch her eyes, nose and mouth if she hasn’t washed her hands.
- Avoid close contact with people who are sick (no kissing, hugging or sharing cups or utensils).
- Disinfect the objects and surfaces that your child regularly touches, like doorknobs and toys.
Even diagnosing the illness can be tricky. While some hospitals and doctor’s offices can test for an enterovirus infection, most won’t be able to determine the type of the virus, and therefore, won’t be able to make a diagnosis of EV-D68. Only the CDC and some state health departments can test for the virus using more complicated testing methods.
When to see your doctor
If your child is having trouble breathing or experiencing muscle weakness or having trouble walking — which are symptoms of AFM — you should see a doctor or take them to ER right away. In rare cases, muscle weakness can cause difficulty breathing or instability in blood pressure.
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