Beyond the Headlines: Enterovirus D68’s potential link to deaths, paralysis

In light of recent news reports of pediatric deaths and neurological symptoms potentially associated with Enterovirus D68, pediatric infectious diseases specialist, Ravi Jhaveri, MD, cuts through the fear with this update.

National news outlets are reporting the deaths of four patients infected with Enterovirus D68 (EV-D68), the virus causing severe respiratory illness in children across the country. While this tragic news is certain to cause alarm among concerned parents, it is important to note that, so far, no deaths have been directly attributed to the virus.

Determining whether EV-D68 was a contributing factor in these deaths will take some time. In the meantime, we do not want families to panic or needlessly worry. Keep these points in mind:

  • EV-D68 can be detected for several weeks after someone is infected. This is true throughout the Enterovirus family. Given the prevalence of Enterovirus infections (an estimated 10 million to 15 million per year according to the CDC), these children may have had the infection several weeks before they presented with another illness.

  • In the most widely reported death, that of the 10-year-old girl from Rhode Island, she was determined to have a severe bacterial infection caused by Staphylococcus aureus, a bacteria known to be resistant to many antibiotics. This is a much more likely cause of severe symptoms leading to death. The larger reports of EV-D68 have shown that while children with asthma can have a period of severe respiratory difficulty, the symptoms improved very quickly.

On a separate but related note, there are reports of children with the sudden onset of neurological symptoms, including muscle weakness in their limbs. Some of the affected patients have tested positive for EV-D68, and there is reason to believe this may be directly linked to the virus. EV-D68 is in the same viral family as Poliovirus, and other Enteroviruses have been linked to these “polio” like paralysis symptoms.

In both matters, the deaths and the neurological illnesses, it is important that we allow the medical authorities to gather and analyze all available information and see what conclusions they draw. Regardless, the fact remains that the great majority of infections are very mild (most won’t even realize they were infected with EV-D68).

Our advice remains that families should be vigilant about hand-washing and infectious precautions, like disinfecting frequently touched surfaces, staying home when sick, and avoiding close contact with those who have respiratory illnesses. We expect that as the weather gets cooler, Enterovirus circulation will decline

And while that is welcome news, with cooler weather, we are likely to see a corresponding increase in influenza related illness. Have you gotten your flu shot yet?

Related Links

Enterovirus D68: What families need to know

Submitted by: Ravi Jhaveri, MD, Associate Professor of Pediatrics, UNC School of Medicine

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