Enterovirus Cases Expected to Spike Nationwide Due to Specimen Backlog

Respiratory illness now confirmed in 27 states, with significant growth expected in coming weeks.

A severe respiratory illness infecting children across the United States continues to spread, but medical officials are stressing that the outbreak is not cause for significant concern.

Cases of enterovirus D68 (EV-D68) have now been confirmed in 27 states, with 175 people infected with the illness, according to the US Centers for Disease Control and Prevention (CDC). Enteroviruses typically infect 10 to 15 million people annually in the late summer and early fall seasons, but the EV-D68 strain has led to more serious complications than the typical flu-like symptoms associated with the illness.

“We don’t entirely understand why this strain is causing so much trouble, particularly for children,” said Claire McCarthy, MD, in a report on Harvard Health. “It may simply be that, because children are young, they haven’t had a chance to build up immunity to enteroviruses in general. But, what we do know is that EV-D68 causes more trouble for children, especially those with asthma.”

Thus far, EV-D68 has been confirmed in Alabama, Arkansas, California, Colorado, Connecticut, District of Columbia, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, North Dakota, Oklahoma, Pennsylvania, Virginia, Washington, and West Virginia.

The CDC expects the number of cases to spike from more states reporting EV-D68 cases in the coming weeks; however, that anticipated increase does not indicate that the situation will become worse.

Mainly, the spike will be attributable to several states that are still awaiting test results from clusters of suspected EV-D68 cases. There is presently a large backlog of specimens awaiting testing, which is slower and more complex because the process can only be done by the CDC and a limited number of public health laboratories.

“As the backlog of specimens is processed, the number of states and confirmed cases will likely increase,” the CDC said in a statement posted on its website. “These increases will not necessarily reflect changes in real time, or mean that the situation is getting worse.”

Symptoms for EV-D68 include fever, runny nose, difficulty breathing, muscle aches, hypoxemia, and possible wheezing. Approximately two-thirds of confirmed EV-D68 patients had a previous medical history of asthma.

Individuals with pre-existing respiratory conditions are especially prone to severe EV-D68 infections. There are no vaccines or specific antiviral medications for the virus.

Although EV-D68 has hospitalized children in dozens of states, no deaths have occurred. In contrast, the seasonal flu causes thousands of deaths every year, according to the CDC.

EV-D68 is spread through contact with body fluids, such as saliva and nasal secretions. Frequent hand washing is one of the best methods to reduce the chances of infection.

Parents of children with asthma are urged to be mindful and seek medical attention if their child begins to exhibit symptoms.

“Most likely, it is a simple cold and nothing serious, but do stay alert for signs of breathing difficulties,” Dr. McCarthy said in the Harvard Health report. “These include coughing very frequently, breathing fast or heavy, having trouble talking, or looking pale. These are signs you should get medical attention right away.”