ENTEROVIRUS D68 (EV-D68): UNRAVELING THE MYSTERY

Course overview

Enteroviruses alone, excluding the poliovirus, cause about 10 to 15 million infections in the United States each year. Tens of thousands of individuals are hospitalized each year for illnesses caused by enteroviruses. Enterovirus D68 (EV-D68, EV68, HEV68) is a member of the Picornaviridae family, an enterovirus. First isolated in California in 1962 and once considered rare, EV-D68 has been on a worldwide upswing in the 21st century. In 2014, the United States experienced a nationwide outbreak of EV-D68 associated with severe respiratory illness. From mid-August 2014 to January 15, 2015, the CDC or state public health laboratories confirmed 1,153 total cases of respiratory illness caused by EV-D68 in 49 states and the District of Columbia. Almost all of the confirmed cases were among children, many of whom had asthma or a history of wheezing. Additionally, there were likely millions of mild EV-D68 infections for which individuals did not seek medical treatment and/or get tested. The CDC received about 2,600 specimens for enterovirus laboratory testing during 2014, which is substantially more than usual. About 36% of those tested positive for EV-D68. About 33% tested positive for an enterovirus or rhinovirus other than EV-D68. EV-D68 was detected in specimens from 14 patients who died and had samples submitted for testing. State and local officials have the authority to determine and release information about the cause of these deaths. The pain and suffering caused by the enteroviruses and the upsurge specifically in EV-D68 infections has caused the world to pause, backup and investigate retrospectively why this upsurge in activity and how better can we as healthcare providers prevent EV-D68 infections in the future before EV-D68 raises its ugly head again.