Enterovirus D68 Infection in the United States

18 Sep 2014

An increase in reports of respiratory illness in children has been ongoing in the United States (US) since the middle of August 2014. The cause of the illness has been identified as an enterovirus (strain EV-D68).

As of 17 September 2014, a total of 140 cases of respiratory illness caused by EV-D68 have been laboratory confirmed. The following 16 states have laboratory confirmed cases: Alabama, Colorado, Connecticut, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, Montana, Nebraska, New York, Oklahoma, Pennsylvania, and Virginia. Several other states are reporting clusters of suspected cases and investigations are ongoing.

Further new cases are expected as the US is in the middle of the enterovirus season and the number of cases will increase as laboratory confirmation takes time and can only be done in US laboratories, therefore a backlog is predicted.

At present there is no vaccine available and no specific treatment for EV-D68; clinical care is supportive. Symptoms may include fever, runny nose, sneezing, cough, and body and muscle aches. Those with pre-existing conditions, such as asthma or other respiratory conditions, may be particularly susceptible to severe infections from EV-D68.

Advice for Travallers

As EV-D68 causes respiratory illness, the virus can be transmitted via respiratory secretions e.g. saliva, nasal mucus or sputum from an infected individual. Infection is spread person to person when an infected individual coughs, sneezes, or touches and contaminates surfaces.

Travellers should reduce the risk of respiratory illness by practicing good hand hygiene:

• Wash hands often with soap and water, especially after changing nappies.
• Avoid touching eyes, nose and mouth with unwashed hands.
• Avoid kissing, hugging, and sharing cups or eating utensils with people who are unwell.
• Disinfect frequently touched surfaces, such as toys and door handles, especially if someone is sick.