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Enterovirus D68

Health Issue
Enterovirus D68, also known as EV-D68, is a member of the family of enteroviruses that was discovered for the first time in the USA in 1962. The virus first expresses itself through common cold-like symptoms that might range from fever, sneezing and coughing up to difficulty in breathing requiring hospitalization, or even death in some cases. Neurologic symptoms such as muscle weakness or paralysis have been detected in some cases that were confirmed to have been infected with EV-D68. Whereas adults can be infected with this virus, children and young adolescents appear to be at higher risk, possibly due to a lack of prior exposure to the virus. Having a pre-existing respiratory illness such as asthma exacerbates the vulnerability to infection by EV-D68. Human to human transmission occurs through droplet infection via coughing, sneezing, or kissing, or via contact with articles and surfaces contaminated with body secretions from an infected person such as saliva or mucus. Treatment of cases is restricted to supportive measures and medications to alleviate the symptoms, as there is currently no vaccine against EV-D68.


Health officials expect surge in enterovirus D68 cases affecting kids
Mike Stobbe, The Associated Press, October 14, 2014

Mystery surrounds enterovirus D68, possible link to paralysis Staff, October 12, 2014

Michigan girl, 21 months, becomes second confirmed child death from enterovirus D68 this year: Parents mourn their 'angel' as mystery illness continues to sweep the U.S.
Sophie Jane Evans, Daily Mail, October 11, 2014 

Enterovirus D68: 2nd child in U.S. dead from enterovirus strain. Toddler is the 1st in Michigan reported to have died from the virus
Thomson Reuters, October 11, 2014 

CHEO sees 8 more D68 cases, all have recovered
Dani-Elle Dube, Ottawa Sun, October 09, 2014

Child with muscle weakness tests positive for Enterovirus D68 at SickKids
Olivia Carville, Toronto Star, October 08, 2014 

After Death of New Jersey Boy From Enterovirus 68, Worry Grows Among Parents
Marc Santora, New York Times, October 6, 2014

Health officials link paralysis in two children to enterovirus D68
Annalise Klingbell, Calgary Herald, October 06, 2014

Toronto doctors testing three children with muscle weakness for enterovirus D68
Maria Babbage, The Canadian Press, October 05, 2014

Spread of enterovirus D68 takes an alarming turn with reports of paralysis: What we know and don’t know
Ariana Eunjung Cha, Washington Post, September 30, 2014

Respiratory virus Enterovirus D68 hits the Northeast
Lindsey Bever, Washington Post, September 15, 2014

Afraid of EV-D68? Another Deadly Virus Is Actually Killing Kids in U.S.
Maggie Fox, NBC News


Useful Links

World Health Organization
Enterovirus D68

Centers for Disease prevention and Control, USA
Enterovirus D68

CDC Develops a New, Faster Lab Test for Enterovirus D68

European Centers for Disease prevention and Control
Rapid Risk Assessment on EV-D68

Public Health Agency of Canada
Public Health Update: Enterovirus-D68

National Collaborating Centre for Infectious Diseases, Canada
Disease Debrief: EV-D68

Public Health Ontario
Enterovirus D68


Further Reading

Shaw J, Welch T, Milstone A. (2014). The Role of Syndromic Surveillance in Directing the Public Health Response to the Enterovirus D68 Epidemic. JAMA Pediatrics [Epub ahead of print].
Midgley C, Jackson M, Selvarangan R, Turabelidze G, Obringer E, et al. (2014). Severe respiratory illness associated with enterovirus d68 - missouri and illinois, 2014.  MMWR - Morbidity & Mortality Weekly Report; 63(36), 798-9.

Imamura T, Okamoto M, Nakakita S, Suzuki A, Saito M, Tamaki R, et al. (2014). Antigenic and receptor binding properties of enterovirus 68. Journal of Virology; 88(5):2374-84.

Lu Q, Wo Y, Wang H, Wei M, Zhang L, et al. (2014). Detection of enterovirus 68 as one of the commonest types of enterovirus found in patients with acute respiratory tract infection in China. Journal of Medical Microbiology; 63(Pt 3):408-14.

Stephenson J. (2014). CDC tracking enterovirus D-68 outbreak causing severe respiratory illness in children in the Midwest. JAMA; 312(13):1290.

Renois F, Bouin A, Andreoletti L. (2013). Enterovirus 68 in pediatric patients hospitalized for acute airway diseases. Journal of Clinical Microbiology;51(2):640-3.

Meijer A, van der Sanden S, Snijders B, Jaramillo-Gutierrez G, Bont L, et al. (2012). Emergence and epidemic occurrence of enterovirus 68 respiratory infections in The Netherlands in 2010. Virology; 423(1):49-57.

Tokarz R, Firth C, Madhi S, Howie S, Wu W, et al. (2012). Worldwide emergence of multiple clades of enterovirus 68. Journal of General Virology; 93(Pt 9):1952-8.

Xiang Z, Gonzalez R, Wang Z, Ren L, Xiao Y, Li J, et al. (2012). Coxsackievirus A21, enterovirus 68, and acute respiratory tract infection, China. Emerging Infectious Diseases; 18(5):821-4.

Rahamat-Langendoen J, Riezebos-Brilman A, Borger R, van der Heide R, Brandenburg A, et al. (2011). Upsurge of human enterovirus 68 infections in patients with severe respiratory tract infections. J Clin Virol; 52(2):103-6.

Piralla A, Baldanti F, Gerna G. (2011). Phylogenetic patterns of human respiratory picornavirus species, including the newly identified group C rhinoviruses, during a 1-year surveillance of a hospitalized patient population in Italy. Journal of Clinical Microbiology; 49(1):373-6.

Schieble J, Fox V, Lennette E. (1967). A probable new human picornavirus associated with respiratory diseases. American Journal of Epidemiology; 1967 Mar;85(2):297-310.

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