Parents: How Worried Should You Be About Enterovirus D68?

I picked my five kids up at their schools today, and the car was unusually quiet. On any other day, they are fighting for my attention, speaking over each other and generally rowdy with pent up energy from sitting in school all day. “It’s too peaceful in here. What’s wrong?” I asked. Each had a mild, physical complaint, from sore throat, to headache to “I’m just really tired today.” The little ones, who go to preschool, have a runny nose and a mild cough. I’ve noticed some of their classmates with the same symptoms.

This is about what you’d expect if we had a benign cold virus making its way through our home. It wouldn’t be the first time we all had a “touch of something”, and I normally am not prone to worry. However, this is the first time they are all under the weather with enterovirus D68 making its way around the country. Here in New Jersey, we are living in the tragic shadow of the death of a four-year old boy from this particularly virulent enterovirus. Eli Waller’s parents put him to bed with symptoms of pink eye, and he passed overnight. It’s a parents’ worst nightmare, and as we pray for the Wallers, we can’t help but put ourselves in their shoes. Can this happen to me? Can it be prevented? What should I know about this virus?

Enteroviruses usually cause run of the mill upper respiratory illnesses or colds. The EV-D68 strain has been diagnosed in over 600 people in the U.S. this year, and is implicated in four deaths to date. Between this and Ebola, you may be thinking of quarantining your family. I can’t blame you. The reports are frightening, especially for parents. The best you can do is to be informed and stay vigilant, but remain calm.

Enteroviruses are spread the same as any cold virus – through saliva and mucous. People become infected when they touch a contaminated surface and bring the virus to their eyes, nose or mouth. Anyone can be infected with EV-D68, but children and those who are immunosuppressed are most likely to have severe symptoms. Kids, because they have not yet built up an immunity to many viruses, the immunosuppressed because they can’t fight off the illness. Because this is a respiratory infection, people with pre-existing respiratory illnesses, such as asthma, are at greater risk of becoming severely ill. There is no specific treatment for EV-D68, and patients are treated with supportive care and on a symptom by symptom basis.

Initial mild symptoms usually include runny nose, sneezing, coughing, body aches and fever. Severe symptoms include wheezing and difficulty breathing.

Bottom line, you don’t need to lie in bed awake at night anxious about EV-D68, but you should be worried enough to do the following:

–       stress to your children how important it is to avoid spreading germs

  • encourage frequent hand washing
  • instruct them to cough and sneeze into their elbow
  • teach them to avoid touching their face, especially around the mouth and nose
  • tell them not to share drinks, lip balm or utensils with other children


–       be vigilant about signs of respiratory distress, especially if your child has asthma or has had breathing problems in the past

  • look for:
    • fever or rash
    • increased rate of breathing
    • increased fatigue
    • use of muscles in the shoulders and chest during breathing
    • wheezing or noisy breathing


–       If you have infants, young children, or children with asthma, be mindful of their contact with individuals who have cold or flu symptoms. Encourage anyone who cares for your child to wash their hands frequently, especially if they are showing some of the early signs of enterovirus infection.

As enteroviruses typically manifest in the spring and fall, we should start to see a decline as we move toward winter. But, before you get too comfortable, flu season is upon us. The above tips are useful not only for EV-D68, but for any contagious viral illness including the flu. The CDC reports more than 100 children died from complications of the influenza virus last year alone. Invest in hand soap and continue to annoy your kids about germ spreading behaviors. An ounce of prevention is truly worth a pound of cure.



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