Enteroviruses as a group are common, and many people who get infected will not feel sick at all.  Other types of illness range from mild cold-like symptoms (e.g., runny nose, cough and sneezing) to fever and rash, to more severe forms such as  trouble breathing and infections of the brain and lining of the spinal cord. 

 

Overall, there are more than 100 different types of enteroviruses. Infants, children and teenagers are more likely to get infections partly because they have not been previously exposed to as many kinds of enteroviruses as adults and have not developed immunity to these viruses. In Canada and the United States, enterovirus infections are more common during the late summer and fall. Enterovirus D68 (EV-D68) is a specific type of non-polio enterovirus.  

EV-D68 causes mild to severe respiratory illness. Mild cold-like symptoms including: 

EV-D68 can also cause more severe respiratory illness. Children with a history of asthma or wheezing are at higher risk for severe illness due to EV-D68 infection. 

Fever may not be a common symptom. Severe respiratory symptoms, such as difficulty breathing, may occur even in the absence of fever.

EV-D68 is found in secretions of the nose, throat and airways (e.g., saliva, nasal mucus or sputum). It can spread from person-to-person when an infected person coughs or sneezes. It can also be spread by having close contact with an infected person or by touching contaminated objects or surfaces.

Most enterovirus infections will cause only mild cold-like symptoms. However, serious complications can occur with EV-D68 infection and include asthma-type symptoms such as wheezing and difficulty breathing, hypoxemia (not getting enough oxygen in the blood), blockage of the air passage, pneumonia and, in severe cases, death. 

While EV-D68 has been mostly known to cause respiratory illness, it is also associated with a rare neurological complication called acute flaccid paralysis, meaning sudden onset of weakness in one or both arms or legs.

Doctors and nurses can test for EV-D68 by collecting a swab from a patient’s nose or throat and submitting it to the BC provincial laboratory for testing. 

Only certain laboratories are able to test patient specimens for enterovirus infection. However, most of these laboratories will be unable to tell if the infection is caused by EV-D68 or some other type of enterovirus. Only the BCCDC Public Health Laboratory can conduct this type of testing and confirm EV-D68 infection. 

The BCCDC does not know how many enterovirus infections occur in BC each year. This is because most people with mild cold-like illness do not seek medical care, testing for enterovirus infection is not routinely done, and public health practitioners are not required to report enterovirus infections to their local health authority. Because patients in hospital are more likely to be tested for enterovirus infection, the cases that are identified are more likely to be severe presentations.

There is no specific treatment or vaccine for EV-D68. Most people will get better on their own without any treatment. 

People with respiratory illness, especially children with a history of asthma or wheezing, should contact their doctor if their symptoms get worse or they have difficulty breathing. Severe cases may need to be hospitalized and occasionally may require intensive care.

The following prevention measures can help reduce the spread of EV-D68 and other respiratory infections:

Parents of children with asthma should make sure their children regularly take their prescribed asthma medication and make sure their symptoms are well controlled. In the event that symptoms worsen, especially difficulty breathing, seek medical attention immediately.