Enterovirus-D68 was first isolated in 1962 and differs from other strains of enterovirus in that patients don't necessarily present with fever. Most parents and practitioners are more familiar with the form of enterovirus responsible for infections such as hand, foot and mouth disease, with symptoms including fever, mouth / throat sores, rash, and gastrointestinal complaints. In contrast, EV-D68 presents primarily with respiratory symptoms.
EV-D68 has recently spread rapidly across the country. The CDC reported that the number of states in the U.S. with confirmed cases increased from 6 to 22 in 1 week. The virus is transmitted via respiratory secretions. Fortunately, there have been no deaths to date from EV-D68 during this outbreak.
The infection presents with worsening cough over several days. Wheezing with a productive cough is a typical presentation, and individuals with underlying conditions such as asthma may be more prone to more severe symptoms, even requiring hospitalization for supportive care, such as supplemental oxygen.
Locally, we are seeing an inordinate number of patients with cough and wheezing this time of year, and many of these patients most likely have EV-D68. Fortunately, most patients seem to be responding well to conventional treatments for wheezing and coughing, such as bronchodilators (such as albuterol), and steroids (either inhaled or oral). There currently are no antiviral medications to treat EV-D68.
Finally, if your child has a productive cough this time of year, don't think allergies first, especially if they have no other allergy symptoms, such as sneezing, watery eyes, or nasal discharge. Have them evaluated by their health care provider to determine what treatment if any is necessary.
Dr. Garabedian received his medical degree from New York Medical College and completed his residency in pediatrics at North Shore University Hospital and Cornell University Medical Center. He is board certified by the American Academy of Pediatrics. Prior to joining Bon Secours Medical Group, Dr. Garabedian was in private practice in Southampton, New York, for 16 years. He is now a pediatrician at Hanover Pediatrics with Bon Secours and can be reached here.
