Enterovirus-D68 Impacting Kids Health

Enterovirus D68:
Frequently Asked Questions for School Health Professionals

What are enteroviruses?
  • Enteroviruses are very common viruses; there are more than 100 different types.
  • Around 10 to 15 million enterovirus infections occur in the United States each year.
  • Most infected people have no symptoms or only mild symptoms, but some infections can be serious.
  • Infants, children, and teenagers are more likely than adults to get infected with enteroviruses and become sick.
  • Most enterovirus infections in the United States occur seasonally during the summer and fall.
  • Enteroviruses can cause respiratory illness, febrile rash, and neurologic illnesses, such as aseptic meningitis (swelling of the tissue covering the brain and spinal cord) and encephalitis (swelling of the brain).
What is enterovirus D68 (EV-D68)?
  • EV-D68 is not a new (novel) virus; it was first identified in California during 1962.
  • EV-D68 infections likely occur less commonly than infections caused by other enteroviruses.
  • Compared with other enteroviruses, EV-D68 infection has rarely been identified in the United States.
What are the symptoms of EV-D68?
  • EV-D68 has been reported to cause mild to severe respiratory illness. However, the full spectrum of EV- D68 illness is not well-defined
  • Some common signs and symptoms may include low-grade fever (although many patients will not be febrile), cough, runny nose, sneezing and body/muscle aches.
  • Signs and symptoms of more severe infections can include wheezing, difficulty breathing, and tachycardia.
  • The occurrence of aseptic meningitis appears to be less frequent with EV-D68 than with other enteroviruses.
  • Infected individuals generally self-recover without complications by treating symptoms. However, some individuals, particularly those with weakened immune systems or underlying medical conditions, such as asthma, may experience severe illness and require hospitalization with supportive therapy.
  • If a person has severe symptoms, such as difficulty breathing, contact a health care provider.
How is EV-D68 spread to others?
  • EV-D68 is found in saliva, nasal mucus, or sputum.
  • The virus is likely spread from person to person when an infected person coughs, sneezes, or touches surfaces.
  • EV-D68 can be spread by fecal-oral transmission, but the extent of transmission by this route is unknown.
How long should students with EV-D68 infection be excluded from school?
  • Students can return to school when their fever has resolved (without fever-reducing medications), and they feel well enough to participate in classroom activities.
Do parents need to be notified if a student in their children's school is diagnosed with EV- D68?
  • No. It is not necessary to notify parents about sporadic cases of EV-D68 infection. If multiple cases are identified, the school should follow their own policies about parental notification.
What can we do to prevent the spread of EV-D68 in schools?
  • There are no vaccines for preventing EV-D68 infections.
  • You can help protect yourself from respiratory illnesses by following these steps:
    o Wash hands often with soap and water for 20 seconds to help prevent transmission of communicable diseases.  
    • If you do not have access to a sink, alcohol hand sanitizers are a good alternative, as long as hands are not visibly soiled.
    • Use of alcohol sanitizers in schools help improve hand hygiene among students and staff and should be available in classrooms and other convenient locations.
    • Alcohol hand sanitizers are less effective against certain viruses such as norovirus and enteroviruses. If there are confirmed cases of these illnesses in households, use soap and water as the preferred way to wash hands.
    o Avoid touching eyes, nose, and mouth with unwashed hands.
    o Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick.
    o Use standard disinfection procedures (e.g., using an EPA-registered disinfectant) for surfaces, such as toys and doorknobs, especially if someone is sick. (EV-D68 does not live long outside the body. Once a surface is dry, it likely does not contain live virus.)
  • As always, remind parents to keep children home when they are sick.
  • Since people with asthma are at higher risk for respiratory illnesses, they should maintain control of their asthma during this time. Asthma can also be controlled by avoiding the triggers that can cause an attack, such as tobacco smoke.
How should school health professionals report an outbreak of respiratory illness?
  • Call your local health department to report confirmed or suspected outbreaks of respiratory disease.
Where can I get more information?

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