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Enterovirus D68 Infection

(EV-D68 Infection)

N-ter-o-vi-rus D68



Enterovirus D68 (EV-D68) is a virus that can cause mild to severe infections of the lungs and breathing passages.


Copyright © Nucleus Medical Media, Inc.


Causes    TOP

EV-D68 passes from person to person through infected fluids of the mouth and nose. When an infected person coughs or sneezes the virus becomes airborne. A nearby healthy person may then inhale the virus. The virus can also exist on a surface once it has been touched by an infected person. The virus can then be transferred when a healthy person touches that surface and then touches their mouth or nose. Not all people who come in contact with the virus will develop an infection.


Risk Factors    TOP

Infants are at increased risk of infection because their immune system has not fully developed. Children and teenagers are at increased risk due to high rate of exposure, poor use of preventive hygiene methods, and a lack of previous exposure that would protect from the virus.

Factors that may increase a child’s chances of a respiratory infection:


Symptoms    TOP

Mild symptoms are similar to a common cold and include:

  • Fever
  • Runny nose
  • Sneezing
  • Cough
  • Muscle aches

More severe symptoms may include:

  • Wheezing
  • Difficulty breathing

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids may be tested if there is a severe or long lasting infection. Evidence of EV-D68 may be found with:

  • Nasal mucus test
  • Throat culture
  • Stool tests
  • Blood tests
  • Lumbar puncture to test the fluid that surrounds the brain and spinal cord

Treatment    TOP

Talk with your doctor about the best treatment plan for you. Options include:

Mild Infections

Mild infections do not need special treatment. The goal is to ease the symptoms while the body fights the virus. Antibiotics are not effective against viruses.

Home care steps can help to relieve symptoms:

  • Drinking plenty of liquids, to help keep nasal fluid thin and easy to clear.
  • Cool-mist vaporizer to humidify the air to help reduce coughing and sooth irritated breathing passages.
  • Salt-water nose drops to loosen mucus in the nose.
  • Over-the-counter medication to reduce pain and fever.

Note: Aspirin is not recommended for children with a current or recent viral infection. Check with the doctor before giving your child aspirin.

Severe Infections

Severe infections cause breathing problems and wheezing. They may require treatment in a hospital. The treatment is aimed at opening up breathing passages and sometimes supporting breathing with oxygen. Treatment may include:

  • Humidified air
  • Supplemental oxygen
  • Medications to improve breathing
  • In certain cases, mechanical ventilation may be used if you or your child is unable to breathe without assistance

Prevention    TOP

There is no vaccine available for EV-D68. To help reduce the chances of a respiratory infection:

  • Wash your hands often. This is especially important after touching someone who may have a cold or other infection.
  • Avoid touching your face and rubbing your eyes.
  • Do not share items such as cups, glasses, silverware, or towels with people who may have a cold or other infection.
  • Disinfect frequently-used surfaces, such as counters and doorknobs.
  • Manage asthma or wheezing conditions as advised by your doctor. This may include getting an influenza vaccine.

Centers for Disease Control and Prevention

American Academy of Allergy Asthma & Immunology


Asthma Canada

Public Health Agency of Canada


Enterovirus D68. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated October 20, 2017. Accessed February 16, 2018.

Enterovirus D68 infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T905971/Enterovirus-D68-infection . Updated July 28, 2016. Accessed February 16, 2018.

Enteroviruses. Oklahoma State Department of Health website. Available at: https://www.ok.gov/health2/documents/Enteroviruses%20%202014.pdf. Updated August 2014. Accessed February 16, 2018.

Enteroviruses and enterovirus D68. Washington State Department of Health website. Available at: https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/EnterovirusD68. Accessed February 16, 2018.

Midgley CM, Jackson MA, Selvarangan R, et al. Severe respiratory illness associated with enterovirus D68—Missouri and Illinois, 2014. MMWR Morb Mortal Wkly Rep. 2014;63(36):798-799.

Last reviewed March 2018 by EBSCO Medical Review Board David L. Horn, MD, FACP
Last Updated: 10/3/2016

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