Pediatric Associates of the NW Blogs

Enterovirus D-68 and the Flu: What You Need to Know Now

M. Allison Baynham, MD
November 09, 2014 03:22PM


As many of you are already aware, there is a public health concern over Enterovirus D68 which has caused severe illness, paralysis, and even death in children recently.  This can be very frightening since the symptoms of enterovirus D68 resemble the symptoms of the common cold, and most parents are wondering what they should be doing to protect their children.  The answer is, you really don’t need to be doing anything differently in terms of EV-D68, but you should be thinking about getting your flu vaccine.

Here are answers to some of the most frequent questions we’ve been asked:

What do you think about Enterovirus D68?

Enterovirus D68 is a virus in a family with >100 enteroviruses, the most well-recognized being polio.

Most enteroviruses either cause no symptoms or a mild cold.

Typically infections are most common in late summer and early fall.

Enterovirus D68 is spread via both fecal-oral and respiratory transmission but has mostly been associated with causing respiratory disease.

This is not a new virus- it was first identified in 1962.  The recent increase in diagnosed cases may be due to a true increase or simply increased recognition now that there is more specific testing available.

What about those kids that were in the intensive care unit?

The majority of children with severe complications were <5 years old and/or had underlying lung disease such as asthma.  Of the 30 patients tested in Illinois and Missouri, 80% tested positive for EV-D68.  Any respiratory illness (flu, cold viruses, etc) has the potential to cause more severe illness in young children or those with asthma.

Doesn’t it cause paralysis?

Nine children in Colorado were hospitalized with limb weakness about 2 weeks after a febrile respiratory infection, but only four tested positive for EV-D68.  This shows us there is a possible connection, but not enough evidence to establish clear a cause and effect relationship.

What do I do if I think my child might have it?

Treatment is supportive- you would care for your child at home the same way as you would with any cough or cold virus.  If you child shows any signs of wheezing or difficulty breathing, you should call your doctor right away or go to the emergency room.  There is no antiviral therapy, and antibiotics do not work since this is not a bacterial infection.

We are not currently testing for EV-D68.  If a cluster of patients develop symptoms consistent with EV-D68, the health department will be notified and arrange for testing to be done by the Center for Disease Control (CDC.)

Should I be more worried about the flu?

Yes! Influenza kills 23, 0000 Americans annually.  Those at greatest risk are infants less than 2 years of age and children with underlying lung disease such as asthma.

Should my child get the flumist or the shot?

We strongly recommend all children receive the flu vaccine this season.  This is the first year that the CDC is recommending children aged 2 years through 8 years receive the flu mist (nasal spray) over the injectable.  Children with chronic illness or asthma may receive the injectable.  Infants under 6 months are too young to receive flu vaccine, so the best protection for them is to ensure all family member and caregivers have been vaccinated.

For more information about Pediatric Associates of the Northwest, vaccine schedules and up-to-date clinic announcements, visit