Enterovirus D68 (EV-D68) is a non-polio enterovirus that has been associated with respiratory illnesses, primarily affecting children and individuals with compromised respiratory systems. In recent years, EV-D68 has gained attention due to outbreaks that have led to severe respiratory conditions and a potential link to acute flaccid myelitis (AFM), a rare but serious neurological condition. Understanding the transmission, symptoms, diagnosis, treatment, and prevention of EV-D68 is crucial in the context of infectious diseases.
What is Enterovirus D68?
Enterovirus D68 is one of the
enteroviruses, which are part of the Picornaviridae family. It was first identified in 1962 in California. Unlike most enteroviruses that typically cause mild infections, EV-D68 is primarily associated with respiratory illness. It gained prominence in 2014 when a large outbreak in the United States resulted in severe respiratory illness in children and raised concerns about its link to neurological conditions.
How is EV-D68 transmitted?
EV-D68 is transmitted through respiratory secretions, similar to the common
cold viruses. It spreads from person to person via coughing, sneezing, or touching surfaces contaminated with the virus. The virus is more active in the late summer and early fall, aligning with the seasonal pattern of other enteroviruses.
What are the symptoms of EV-D68 infection?
The symptoms of EV-D68 infection can range from mild to severe. Common symptoms include runny nose, sneezing, cough, and body and muscle aches. Severe cases can lead to wheezing and difficulty breathing, especially in children with asthma or other respiratory conditions. In rare cases, the virus has been linked to
acute flaccid myelitis, which can cause sudden muscle weakness or paralysis.
How is EV-D68 diagnosed?
Diagnosis of EV-D68 is based on clinical symptoms and confirmed by laboratory tests. Respiratory specimens, such as nasopharyngeal swabs, are tested using
polymerase chain reaction (PCR) assays to detect the virus. It's important for healthcare providers to distinguish EV-D68 from other respiratory pathogens, especially during outbreaks.
What treatment options are available for EV-D68?
There is no specific antiviral treatment for EV-D68 infections. Management focuses on supportive care, which may include supplemental oxygen for those with severe respiratory symptoms and bronchodilators for patients with asthma. Severe cases may require hospitalization. Early intervention and supportive care are critical in managing the symptoms effectively.How can EV-D68 infections be prevented?
Preventing EV-D68 involves basic infection control measures similar to those used for other respiratory viruses. These include frequent handwashing with soap and water, avoiding close contact with sick individuals, and practicing good respiratory hygiene, such as covering coughs and sneezes with a tissue or elbow. Disinfecting commonly touched surfaces can also help reduce the spread of the virus.What is the link between EV-D68 and acute flaccid myelitis?
The link between EV-D68 and acute flaccid myelitis (AFM) is an area of active research. AFM is a rare condition that affects the nervous system, specifically the spinal cord, leading to muscle weakness or paralysis. During outbreaks of EV-D68, an increase in AFM cases has been observed, although a direct causal relationship has not been definitively established. Researchers are investigating the mechanisms by which EV-D68 might contribute to AFM.What are the public health implications of EV-D68?
EV-D68 poses significant public health challenges due to its potential to cause severe respiratory illness and its association with AFM. Outbreaks can strain healthcare systems, especially pediatric units, and highlight the need for robust surveillance systems to detect and respond to emerging infections. Public health authorities emphasize the importance of vaccination against other respiratory illnesses like influenza to reduce the overall burden on healthcare systems.What future research is needed on EV-D68?
Future research on EV-D68 should focus on understanding its pathogenesis, potential links to neurological conditions, and the development of targeted therapies or vaccines. Improved diagnostic tools and surveillance systems are essential for early detection and response to outbreaks. Research into the genetic and environmental factors that influence the severity of EV-D68 infections is also crucial for developing effective prevention strategies.In conclusion, while EV-D68 is not new, its recent resurgence and association with severe illnesses underline the importance of ongoing vigilance in infectious disease monitoring and response. Public health efforts should continue to focus on prevention, early detection, and supportive care to mitigate the impact of EV-D68 infections.
