Enterovirus Found in 4 Recently Deceased Children

October 2, 2014
Davy James, Associate Editor

Four children who recently died have tested positive for enterovirus D68, though it is not yet clear what role, if any, the virus played in their deaths.

Four children who recently died have tested positive for enterovirus D68 (EV-D68), though US officials note it is not yet clear what role, if any, the virus played in their deaths.

The death of a 10-year-old child from Rhode Island on September 22, 2014, was the first to be recorded with a confirmed presence of EV-D68. The Rhode Island Department of Health reported that the child died from Staphylococcus aureus sepsis associated with EV-D68.

"We are all heartbroken to hear about the death of one of Rhode Island's children," said Michael Fine, MD, director of the Rhode Island Department of Health, in a press release. "Many of us will have EV-D68. Most of us will have very mild symptoms and all but very few will recover quickly and completely. The vast majority of children exposed to EV-D68 recover completely."

Dr. Fine told CNN that the child’s death was clearly due to sepsis and it was unclear what role EV-D68 played.

Yesterday, the US Centers for Disease Control and Prevention (CDC) announced that 500 patients in 42 states have now tested positive for EV-D68, and 4 patients with the virus have died.

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.

The CDC is currently investigating whether there is a link between EV-D68 and several recent cases of muscle weakness or paralysis in 9 children from Colorado. The virus was found in 4 of 8 children, while the status of the ninth child has not yet been confirmed, according to the National Institutes of Health.

The NIH noted that EV-D68 can cause paralysis, but other germs can as well, and the actual cause of the symptoms in the 9 Colorado children has not yet been determined. It is not known whether the weakness or paralysis is temporary or chronic.

"It could be something else. That doesn't prove cause and effect, but it's circumstantial evidence," Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases told CNN.

Doctors at the Children’s Hospital in Boston are also investigating whether the cause of limb weakness in 4 pediatric patients with a respiratory illness is related to EV-D68.

“Now we have an outbreak of EV-D68 on a widespread basis and polio-like symptoms on a widespread basis,” said Keith Van Haren, MD, in a report on the Boston Herald. “It would be a really remarkable coincidence if these 2 events were unrelated.”

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.

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.