Introduction:
EV-D68 is one of more than 100 types of non-polio enteroviruses. It was identified in 1962 in California. The symptoms of this respiratory illness can range from mild to severe. This infection was not prevalent in the United States until 2014. But, in 2014, an EV-D68 epidemic occurred in almost every state across the United States. The majority of the victims were children. The infection usually occurs in the late summer or early fall. The onset of the symptoms is generally mild and resembles a common cold. Unless one gets extremely sick, they might be unaware of the fact that they have been infected with the EV-D68 virus.
What Are Enteroviruses?
Enteroviruses belong to a group of viruses that trigger different kinds of communicable (spreads from one person to another) diseases. More than 300 types of enteroviruses exist. EV-D68 is a type of enterovirus that attacks the respiratory system. EV-D68 is categorized under the non-polio enterovirus category by the healthcare community.
More than 100 types of non-polio enteroviruses exist. Similar to the virus that causes polio, a few of these enteroviruses attack the nervous system. They can cause various health issues like hand, foot, and mouth disease, meningitis (inflammation of the protective envelope surrounding the brain and the spinal cord), encephalitis (inflammation of the brain as a result of infection), and acute flaccid myelitis (a condition that results in extreme muscle weakness).
Who Can Develop EV-D68 Infection?
Infants and children are more vulnerable to developing EV-D68 infection. Adults are comparatively less affected due to their previous history of exposure to the virus. While adults can suffer from mild or no symptoms, children, especially those with asthma, can suffer from severe symptoms. The first national outbreak of EV-D68 was in the year 2014, and about 1,400 children and adults suffered from a severe respiratory illness that required treatment at the hospital. Similar outbreaks occurred in 2016 and 2018, but the symptoms were mild.
What Is the Mode of Transmission of the EV-D68 Virus?
The mode of transmission of the virus is through:
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Saliva.
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Phlegm.
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Nasal fluids.
The virus can spread when a person coughs or sneezes, touches an object handled by the sick person, and then touches their own eyes, nose, or mouth, or through close contact like hugging, shaking hands, or kissing a person infected with the virus. It can also spread through contact with the poop of an infected person, such as when helping a child use the restroom or when changing the child’s diaper.
Can Enterovirus D68 Pose a Threat to Pregnant Women?
Most pregnant women would have developed considerable immunity against the EV-D68 virus through their previous exposures. The virus does not seem to pose any harmful threat during pregnancy. There are minor chances of the infection spreading to the baby during delivery or breastfeeding. It is always safe to consult a physician if a pregnant or lactating mother feels ill.
What Are the Symptoms of EV-D68 Infection?
The symptoms can be mild, severe, or a few can even be asymptomatic. Mild symptoms may encompass a runny nose, cough, sneezing, and body and muscle aches. Severe symptoms include difficulty breathing and wheezing. It is wise to consult a practitioner if the symptoms worsen or one has difficulty breathing. EV-D68 can cause a rare but serious neurologic condition called acute flaccid myelitis (AFM), wherein the muscles and the reflexes in the body become weak. Medical attention is mandatory if one notices the following symptoms after a respiratory illness:
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Pain in the back, neck, arms, or legs.
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Weakness in the arms or legs.
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Slurred speech or difficulty swallowing.
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Drooping eyelids or difficulty in the motility of the eyes.
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Facial droop or weakness.
Is It Possible to Get Infected With EV-D68 More Than Once?
EV-D68 is like the common cold or flu; hence, it is possible to get infected more than once. The good news with recurrent exposure is that one gains better immunity to fight off the virus. This is the reason why adults have either mild symptoms or are asymptomatic.
How Can Enterovirus D68 Be Diagnosed?
The physician might suspect EV-D68 infection if a person presents with the related symptoms, especially if there are any recent outbreaks in the particular area or region. Specific lab tests may be done based on the samples obtained from the nose, throat, and blood, which are then examined in the laboratory.
Highly specialized lab tests are required to narrow down the EV-D68 virus. Hence, the samples must be sent to the state health departments or the Centers for Disease Control and Prevention (CDC) as they use molecular sequencing methods or real-time reverse transcription polymerase chain reaction (RT-PCR) testing. These tests are preferred only when the cause of respiratory illness in seriously ill patients is difficult to detect.
How Can Enterovirus D68 Be Treated?
Individuals with mild symptoms of EV-D68 infections usually recover within a week or two with appropriate care and treatment at home. Anti-viral medications are not effective against these viruses. One can gain relief from the symptoms by:
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Drinking plenty of fluids and taking ample rest.
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Taking hot, steamy showers to relieve congestion.
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Taking over-the-counter medications or nonsteroidal anti-inflammatory drugs (NSAIDs) to obtain relief from pain and fever.
What Preventive Measures to Be Followed to Protect Oneself From EV-D68 Infection?
The preventive measures include:
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One must contact their practitioner and discuss the asthma action plan (a written plan developed with a doctor to prevent or control asthma attacks).
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One must always keep the reliever medication with themselves.
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The prescribed asthma medications, especially long-term control medications, should be taken appropriately as directed by the health care professional.
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Getting a flu vaccination every year.
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One must cough or sneeze into the crook of their elbow.
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Commonly touched surfaces or objects like toys, doorknobs, or countertops should be regularly disinfected.
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One can wear masks while going out, especially if they are at a high risk of acquiring serious illnesses from such infections.
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One must not share utensils, towels, clothing, or other personal items with anyone.
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Ill children should be kept away from other healthy classmates and family members.
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One must wash their hands with soap and water for at least 20 seconds.
What Steps Can Be Taken by the Parents of Children With Asthma to Protect the Children From Enterovirus D68 Infection?
The following steps can be taken:
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Parents can help their kids in following the asthma action plan.
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Parents must discuss with a pediatrician (an expert who treats the diseases of children) and plan in advance and discuss when the symptoms would require immediate medical care.
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The reliever or rescue medication, like an inhaler or nebulizer, must always be kept handy.
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Asthma medications, especially long-term control medications, should be given to the child as the pediatrician instructs.
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The child must be vaccinated with the seasonal influenza vaccine as soon as it is available since an influenza infection in the lungs can set off asthma attacks and can worsen the symptoms.
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Parents must ensure that the child’s teacher or caregiver knows their condition and how to tackle it if they face asthma-related symptoms.
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Parents and other family members must refrain from smoking in the vicinity of children with asthma.
Conclusion:
Enterovirus D68 is an infection caused by an enterovirus, and most people do not suffer any serious symptoms and might even be unaware that they have been infected with the virus. Children and adults with poor immunity or respiratory issues like asthma might suffer from severe illness and may require hospitalization. Very rarely, the infection might result in a condition called acute flaccid myelitis which can cause muscle weakness. One can avoid contracting the enterovirus D68 viral infection by following suitable preventive measures.
