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Highlights & Basics
- Enterovirus D68 (EV-D68) is an important cause of viral lower respiratory tract illness in children.
- Most people infected have mild symptoms such as runny nose, cough, sneezing, or muscle aches; some patients have fever. Often patients with more severe disease have a history of asthma or chronic lung disease.
- EV-D68 infection is associated with the polio-like disease acute flaccid myelitis, and there is increasing evidence for a causal connection between the virus and this serious neurologic complication.
- Diagnosis is clinical. Most clinical tests for rhinovirus do not distinguish EV-D68 in the absence of specific testing.
- Specific testing for EV-D68 should be considered in children with severe unexplained respiratory illness, even in the absence of fever. Although not routinely available, specific testing can be obtained on a case-by-case basis through state or local health departments, or the Centers for Disease Control and Prevention (CDC).
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Citations
Oermann CM, Schuster JE, Conners GP, et al. Enterovirus D68: a focused review and clinical highlights from the 2014 United States outbreak. Ann Am Thorac Soc. 2015 May;12(5):775-81.[Abstract]
Midgley CM, Jackson MA, Selvarangan R, et al. Severe respiratory illness associated with enterovirus d68 - missouri and illinois, 2014. MMWR Morb Mortal Wkly Rep. 2014 Sep 12;63(36):798-9.[Abstract][Full Text]
Greninger AL, Naccache SN, Messacar K, et al. A novel outbreak enterovirus D68 strain associated with acute flaccid myelitis cases in the USA (2012-14): a retrospective cohort study. Lancet Infect Dis. 2015 Jun;15(6):671-82.[Abstract]
Centers for Disease Control and Prevention. Non-polio enterovirus: clinical overview of enterovirus D68. Apr 2024 [internet publication].[Full Text]
Centers for Disease Control and Prevention. Acute flaccid myelitis (AFM): clinical guidance for the acute medical treatment of AFM. Jun 2024 [internet publication].[Full Text]
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21. Pons-Salort M, Lambert B, Kamau E, et al. Changes in transmission of Enterovirus D68 (EV-D68) in England inferred from seroprevalence data. Elife. 2023 Jun 9;12:e76609.[Abstract][Full Text]
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23. Sejvar JJ, Lopez AS, Cortese MM, et al. Acute flaccid myelitis in the United States, August-December 2014: results of nationwide surveillance. Clin Infect Dis. 2016 Sep 15;63(6):737-45.[Abstract][Full Text]
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27. Skowronski DM, Chambers C, Sabaiduc S, et al. Systematic community- and hospital-based surveillance for enterovirus-D68 in three Canadian provinces, August to December 2014. Euro Surveill. 2015;20(43).[Abstract][Full Text]
28. Pfeiffer HC, Bragstad K, Skram MK, et al. Two cases of acute severe flaccid myelitis associated with enterovirus D68 infection in children, Norway, autumn 2014. Euro Surveill. 2015 Mar 12;20(10):21062.[Abstract]
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30. Williams CJ, Thomas RH, Pickersgill TP, et al. Cluster of atypical adult Guillain-Barré syndrome temporally associated with neurological illness due to EV-D68 in children, South Wales, United Kingdom, October 2015 to January 2016. Euro Surveill. 2016;21(4).[Abstract][Full Text]
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37. Caylan E, Weinblatt E, Welter J, et al. Comparison of the Severity of Respiratory Disease in Children Testing Positive for Enterovirus D68 and Human Rhinovirus. J Pediatr. 2018 Jun;197:147-53.e1.[Abstract][Full Text]
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43. Centers for Disease Control and Prevention. Acute flaccid myelitis (AFM): testing and diagnosis for AFM. Jun 2024 [internet publication].[Full Text]
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