Enterovirus D68: What Parents Need to Know

This virus may not be top of mind amid cold, flu, and COVID-19, but it carries risks.

Parent helping a child blow their nose

Medically reviewed in July 2021

Updated on March 11, 2022

Children are subject to a wide range of respiratory infections caused by viruses, including colds, flu, and COVID-19. One you may not have heard as much about is severe enterovirus. On occasion, outbreaks of this virus send children to the hospital, some of them to the intensive care unit.

A particularly nasty strain is called enterovirus D68 (also called EV-D68). Outbreaks of EV-68 have been reported in 2014, 2016, and 2018.

Read on to learn more about this virus and what you can do to protect your family.

What is EV-D68?
Enterovirus D68 is a rare virus most commonly found in children. It primarily causes mild to severe respiratory illnesses. The virus belongs to a family of enteroviruses that cause 10 to 15 million infections in the United States each year.

Usually, enteroviruses just cause a bad cold and don’t warrant a trip to the emergency room, let alone a hospitalization. Rarely, however, enteroviruses can cause other illnesses such as a rash with fever and more severe illness such as meningitis and encephalitis. Enteroviruses tend to spread in summer and fall, but they can still cause infections year-round.

What are the symptoms?
Infection with enterovirus D68 initially starts as a cold, maybe with a cough. Most children with common cold symptoms will be fine and not need to go to the hospital. But if your child is younger than 5, or has allergies, asthma, or any other chronic medical condition, they are at higher risk of severe illness or complications.

What are the red flags to watch for?
If your child has difficulty breathing, see a healthcare provider (HCP) right away. Signs of difficulty breathing include:

  • Breathing rapidly: Children under 12 months usually breathe about 35 to 45 times per minute. Children between the ages of one and two breathe at rates in the 30s. Kids who are 3 to 8 years old usually breathe at rates in the 20s. Rates higher than that can be a red flag.
  • Flaring nostrils
  • Straining of the breathing muscles, visible in the neck, above the collarbone, between the ribs, or in the abdomen
  • Wheezing

If your child has a high fever, that’s another red flag. Likewise if they are lethargic, experiencing muscle weakness in an arm or leg, having trouble walking, if they have droopy eyelids or face, or if they complain of pain in the neck, back, or limbs. If they have these or develop any other concerning signs, seek medical care. Children with bad allergies and asthma should also be seen by an HCP.

What’s the treatment?
There’s no specific cure for EV-D68. As with many viral illnesses, the key is “supportive care,” which means giving the body what it needs for support while it defeats the virus itself. In cases requiring hospitalization, this means IV fluids and breathing treatments. In more severe cases, this can include breathing tubes and ventilators to breathe for the patient while the body has time to heal itself.

Can enterovirus D68 be prevented?
There’s no vaccine for enteroviruses. But since the virus is spread through close contact—including coughing, sneezing, or touching contaminated surfaces—there are some things you can do to keep your family healthy. Some of them may seem downright impossible with small children, which is why that age group is so prone to spreading and catching this and other contagious infections. Here are some prevention basics:

  • Wash your hands in hot, soapy water for at least 20 seconds, especially after going to the bathroom or changing diapers. Help younger children and remind older children of the importance of thorough hand washing with soap.
  • Clean and disinfect surfaces regularly touched by multiple people, such as doorknobs and fridge handles.
  • Teach children to cough and sneeze into their shirt sleeve or a tissue, not their hands.
  • Regularly disinfect children’s school supplies, such as pencils, and encourage kids not to share them.
  • Stay home, or keep your child home, if you or your child is sick.
  • Avoid sharing eating utensils like cups and avoid close physical contact with anyone who is sick.
  • Avoid touching your face with unwashed hands.
Article sources open article sources

Centers for Disease Control and Prevention. Enterovirus D68. Page last reviewed August 11, 2021.
Mayo Clinic. What is enterovirus D68 and how can I protect my child from it? October 22, 2020.

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