UMEM Educational Pearls

Category: Pediatrics

Title: Enterovirus D68

Posted: 9/12/2014 by Rose Chasm, MD (Updated: 2/27/2020)
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  • The human enterovirus D68 is a rare virus closely related to the rhinovirus which causes the common cold.  However, there have been recent outbreaks throughout the midwest and the areas are rapidly expanding.
  • Mild symptom onset of rhinorrhea and cough rapidly progress to hypoxia and respiratory distress.
  • Key features are the rapid progression, presence of wheezing even without a history of reactive airway disease, and typically an absence of consolidation on chest XR.
  • Children under 5 years and those with asthma are at the greatest risk for respiratory failure.
  • There are a limited number of labs in the US which test specifically for EV-D68. At UMMC, the Luminex respiratory virus panel can be ordered using the kit form which includes a flocked swab and viral transport media.  Unfortunately, the panel does not differentiate between the closely related enterovirus and rhinovirus. 
  • There is no definitive cure, rather only supportive care and low-threshold for admission/observation for high risk patients.

References

Severe Respiratory Illness Associated With Enterovirus D68--Missouri and Illinois, 2014. CDC MMWR. Vol 63. September 2014.