New Jersey Department of Health
Enterovirus‐D68 (EV‐D68) Frequently Asked Questions
September 18, 2014
What are enteroviruses?
Enteroviruses(EV)arecommonviruses;therearemorethan100types. Itisestimatedthat10‐15millionEVinfectionsoccurintheUSeachyear. MostpeopleinfectedwithEVhavenosymptomsoronlymildsymptoms,butsomeinfectionscanbeserious. ThespreadofEVisunpredictableanddifferenttypesofEVcanbecommonindifferentyearswithnopattern.PeoplearemorelikelytogetinfectedwithEVinfectionsinthesummerandfall.
What is Enterovirus‐D68 (EV‐D68)?
Enterovirus‐D68(EV‐D68)isatypeofEVfirstdetectedin1962inCalifornia.EV‐D68isthoughttooccurlessoftenthanothertypesofEV.
What is the current situation in the U.S. and EV‐D68?
InAugust,severelyillchildrenwithEVwerereportedinMissouriandIllinois. TheEVstrain(type)wasidentifiedasD68bytheCentersforDiseaseControlandPrevention(CDC). AmongtheEV‐D68casesinMissouriandIllinois,childrenwithasthmaseemedtohaveahigherriskforsevererespiratoryillness.
TheCDCiscurrentlyworkingwithstatehealthdepartmentstodeterminetheexactriskfactorsforEVD68.Frommid‐AugusttoSeptember17,2014,atotalof17states(AL,CT,CO,IL,IN,IA,KS,KY,LA,MO,
MT,NJ,NY,NE,OK,PA,VA)haveconfirmedrespiratoryillnesscausedbyEV‐D68.Nodeathsdueto
EV‐D68infectionhavebeenconfirmed.TheNewJerseyDepartmentofHealth(NJDOH)confirmedthatEV‐D68waspresentinthestateonSeptember17,2014.
Forup‐to‐datelistingofstateswithconfirmedEV‐D68cases,gototheCDC’swebsite:
What are symptoms of EV‐D68 infection?
Symptomsmayrangefrommildtosevere.Mildsymptomsmayincluderunnynose,sneezing,cough,bodyandmuscleachesandsometimesfever.Severesymptomsincludedifficultybreathing,wheezingandworseningofasthma. Hospitalizationinanintensivecareunitmayberequired.
How is EV‐D68 infection spread?
EV‐D68isspreadthroughclosecontactwithinfectedpeople. Theviruslikelyspreadsfrompersontopersonwhenaninfectedpersoncoughsorsneezes.Youcanalsobecomeinfectedbytouchingobjectsorsurfacethathavethevirusonthemandthentouchingyourmouth,noseoreyes. Enterovirusesarealsopresentinpoop(stool)andcanbepassedontootherswhenapersontouchespoopanddoesnotwashtheirhands.
Who is at risk for EV‐D68?
Infants,childrenandteenagersaremostlikelytogetinfectedwithEVandbecomesick.Thisismostlikelybecausetheydonothaveprotection(immunity)orbecauseofnopreviousexposuretothisvirus.Childrenwithasthmaseemtohaveahigherriskforsevererespiratoryillness.Infantsandpeoplewithweakenedimmunesystemshaveagreaterchanceofcomplications.AdultscangetinfectedwithEVandaremorelikelytohavenosymptomsormildsymptoms.
How is EV‐D68 diagnosed?
EV‐D68canonlybediagnosedbydoingspecificlabtestsonspecimensmostoftentakenfromaperson’snoseandthroat. Manyhospitalsandsomedoctor’sofficescantestillpatientstoseeiftheyhaveanEVinfection. However,mostcannotdospecifictestingtodeterminethetypeofEV,likeEV‐D68.InNewJersey,samplesaresenttotheCDCtodeterminethetypeofEV.
How is EV‐D68 treated?
ThereisnospecificmedicationforEV‐D68infections. Antibioticsdonottreatviruses,andwillhavenoeffectonEV‐D68.Formostpeople,notreatmentisneeded,thoughmedicationmayhelpcontrolsomesymptoms. Aspirinshouldnotbegiventochildren.Thosewithsevererespiratoryillnessmayneedtobehospitalizedandreceiveintensivecare.TestingforEV‐D68doesnotchangethetreatmentanillchildwillreceive.
How can I protect myself from becoming infected with EV‐D68?
ThereisnovaccinetopreventEV‐D68infections. However,youcanprotectyourselffromEV‐D68andotherEVinfectionsifyou:
•Washhandsoftenwithsoapandwaterfor20seconds,especiallyafterchangingdiapersoEnterovirusisfoundinpoop(stool).Goodhandhygieneisimportantforanyonewhocomesintocontactwithpoop.
oHandsanitizerisnoteffectiveagainstEV
•Avoidtouchingeyes,noseandmouthwithunwashedhands
•Usegoodrespiratoryhygiene;coughingandsneezingintoatissueorelbowandproperlydisposingoftissues.FormoreinformationaboutrespiratoryhygieneseetheCDCwebsiteat
•Avoidkissing,huggingandsharingcupsoreatingutensilswithpeoplewhoaresick
•Cleananddisinfectfrequentlytouchedsurfaces,suchastoysanddoorknobs,especiallyifsomeoneissick.
•StayhomewhenfeelingsickandconsultyourhealthcareprovideroSincepeoplewithasthmaareathigherriskforrespiratoryillnesses,theyshouldtaketheirmedicineasdirectedbytheirhealthcareprovider
•Stayuptodatewithimmunizations,especiallyinfluenza.ThiscanprotectagainstofothercommoninfectionsandlessentheriskofhavingamoresevereillnessifyouareinfectedwithEV‐D68atthesametimeasinfluenza.
How concerned should parents be about the ED‐V68?
Enteroviruses(EV)arecommonviruseswithmorethan100differenttypesthatarearoundmostlyinthesummerandfall.EVinfectionscancausemildorseveresymptoms,andaremorecommonininfants,childrenandteenagers.Parentswhohavechildrenwithasthmashouldmakecertainthattheirchild’sconditioniswellmanaged. Allparentsshouldencouragegoodhandwashingandrespiratoryhygienetopreventillness.Ifachildbecomesillorhasdifficultybreathing,parentsshouldconsultwiththeirhealthcareprovider.
What is respiratory hygiene?
Respiratoryhygieneincludescoughingandsneezingintoatissueorarm/elbowandthenproperlydisposingofthetissue. HandsanitizerisnoteffectiveagainstEV.FormoreinformationaboutrespiratoryhygieneseetheCDCwebsiteat
What should parents of children with asthma know about EV‐D68?
Itisimportantthatasthmaiswell‐treatedandcontrolled.Childrenwithasthmashouldfollowtheirasthmatreatmentplan. Healthcareprovidersshouldbeconsultedinthedevelopmentofasthmatreatmentplans.
If a child is diagnosed with EV or EV‐D68, should they be excluded from school/daycare?
Childrenwithoutafevershouldbeexcludeduntilsymptomfree.Childrenwithafever(oraltemperatureof>100oF)muststayhomeuntiltheyarefeverfreefor24hourswithoutfever‐reducingmedicationandsymptomfree. Forschoolexclusionguidance,goto:
Is there a risk of my child getting ED‐V68 if my child goes to school?
Aswithotherrespiratoryinfections,includingthefluandthecommoncold,thereissomeincreaseinriskofcatchingtheEV‐D68inplaceswithlargenumbersofpeople,suchasschoolsanddaycaresettings.Childrencanprotectthemselvesbywashingtheirhandsoften,nottouchingtheireyesandnosesandcoughingorsneezingintoatissueortheirarm/elbowandproperlydisposingofthetissue. Parentsshouldneversendasickchildtoschool. Anychildwithafeverof100oFormoreshouldstayhomeuntiltheyarefeverfreefor24hours.
What are schools doing about ED‐V68?
Schoolsareencouragedtobevigilantforanyunexpectedincreaseinillnessamongtheirstudentsandreportanysuspectedoutbreakofanyillness,includingED‐V68,totheirlocalhealthdepartment.
TheNJDOHdocument “GeneralGuidelinesfortheControlofOutbreaksinSchoolsandDaycareSettings” providesgeneralguidelinesaboutrespondingtoillnesswhichmayoccurinschoolsanddaycaresettings,suchasexclusioncriteria,preventionandoutbreakresponse. Thedocumentisavailableat:
Why does EV‐D68 seem to affect children more than adults?
Infants,childrenandteenagersaremostlikelytogetinfectedwithEVandbecomesick.Thisismostlikelybecausetheydonothaveprotection(immunity)duetonopreviousexposuretothisvirus.Childrenwithasthmaseemtohaveahigherriskforsevererespiratoryillness.Infantsandpeoplewithweakenedimmunesystemshaveagreaterchanceofcomplications.AdultscangetinfectedwithEVandaremorelikelytohavenosymptomsormildsymptoms.
Is EV‐D68 fatal?
NoconfirmeddeathsassociatedwithEV‐D68havebeenreported.
What should healthcare providers know about EV‐D68?
CliniciansshouldconsiderEV‐D68asapossiblecauseofsevererespiratoryillness,particularlyinchildren. Healthcareprovidersshouldreportunusualincreasesinthenumbersofpatientswithsevererespiratoryillnesstotheirlocalhealthdepartment.
What is the New Jersey Department of Health (NJDOH) doing to respond to EV‐D68? NJDOHcontinuestomonitorthesituationandisincommunicationwithhospitals,localhealthdepartments,healthcareproviders,schoolsanddaycareprovidersabouttestingandclinicalguidance. InconjunctionwiththeCDCandotherpartners,theNJDOHconfirmedthefirstcaseintheNewJerseyresidentonSeptember17,2014. OncethepresenceofEV‐D68isconfirmedinaregion,thereisnoneedforroutinetestingforthisinfection.TestingforEV‐D68doesnotchangethetreatmentanillchildwillreceive.
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