Enterovirus D68 (EV D68)
By now, most of you are aware of a virus, Enterovirus D68 (EV D68) that has been identified in school aged children in a number of states, including NYS. While the virus is not new, it seems to be causing more serious illness this year, especially in children with underlying respiratory problems, like asthma or cystic fibrosis. Not all people who get EV D68 will have severe illness, but if your child shows signs of difficulty breathing or severe wheezing with a respiratory illness, that is a reason to take your child to be evaluated immediately.

If your child has a fresh respiratory illness with mild symptoms such as fever, runny nose, sneezing, cough, body and muscle aches, please do not send your child to school until he/she is fever free off fever reducing medicines and is well enough to stay in class all day and learn. Until then, please allow your child to rest and recover at home.

Since EV-D68 causes respiratory illness, the virus can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum. EV-D68 likely spreads from person to person when an infected person coughs, sneezes, or touches contaminated surfaces. Therefore, frequent hand washing at least every two hours, whenever hands are dirty, after toileting, and before and after eating is important. If soap and water are not available, 60% or greater alcohol based hand sanitizers used with adult supervision are an option. Reminding your children not to share personal items is important. 

There is no specific treatment for people with respiratory illness caused by EV-D68. For mild respiratory illness, you can help relieve symptoms by taking over-the-counter medications for pain and fever, but avoiding aspirin for children, as you would for any viral illness. For severe respiratory illness, please do not delay contacting your physician or other health care provider.

Please be assured that the district is reminding students to use good respiratory etiquette when coughing and sneezing, disposing tissues in a trash can, washing hands when dirty, and not sharing personal items. The school continues to maintain good environmental clean-up with cleaning of high touch surfaces. Yet, it is still good idea to remind your children, especially the little ones, to avoid putting their hands into their mouths or touching their noses or eyes. Thank you for your cooperation.

Overview


Non-polio enteroviruses are very common viruses. They cause about 10 to 15 million infections in the United States each year.

Anyone can get infected with non-polio enteroviruses. But infants, children, and teenagers are more likely to get infected and become sick. That's because they do not yet have immunity (protection) from previous exposures to the viruses.

Most people who get infected with non-polio enteroviruses do not get sick. Or, they may have mild illness, like the common cold. But some people can get very sick and have infection of their heart or brain or even become paralyzed. Infants and people with weakened immune systems have a greater chance of having these complications.

You can get infected with non-polio enteroviruses by having close contact with an infected person. You can also get infected by touching objects or surfaces that have the virus on them then touching your mouth, nose, or eyes.

In the United States, people are more likely to get infected with non-polio enteroviruses in the summer and fall.


Symptoms


Most people who are infected with non-polio enteroviruses do not get sick, or they only have mild illness. Symptoms of mild illness may include:

  • fever
  • runny nose, sneezing, cough
  • skin rash
  • mouth blisters
  • body and muscle aches

Some non-polio enterovirus infections can cause

Less commonly, a person may develop:

  • myocarditis (infection of the heart)
  • pericarditis (infection of the sac around the heart)
  • encephalitis (infection of the brain)
  • paralysis

People who develop myocarditis may have heart failure and require long term care. Some people who develop encephalitis or paralysis may not fully recover.

Newborns infected with non-polio enterovirus may develop sepsis (infection of the blood and other organs). But this is very rare.

Non-polio enterovirus infections may play a role in the development of type 1 diabetes in children.

For information about risks to pregnant women, see Pregnancy & Non-polio Enterovirus Infection.


Transmission

Non-polio enteroviruses can be found in an infected person's

  • feces (stool),
  • eyes, nose, and mouth secretions (such as saliva, nasal mucus, or sputum), or
  • blister fluid.

You can get exposed to the virus by—

  • having close contact, such as touching or shaking hands, with an infected person,
  • touching objects or surfaces that have the virus on them,
  • changing diapers of an infected person, or
  • drinking water that has the virus in it.

If you then touch your eyes, nose, or mouth before washing your hands, you can get infected with the virus and become sick.

Pregnant women who are infected with non-polio enterovirus shortly before delivery can pass the virus to their babies. For more information, see Pregnancy & Non-Polio Enterovirus Infection.

Mothers who are breastfeeding should talk with their doctor if they are sick or think they may have an infection.

Non-polio enterovirus can be shed (passed from a person's body into the environment) in your stool for several weeks or longer after you have been infected. The virus can be shed from your respiratory tract for 1 to 3 weeks or less. Infected people can shed the virus even if they don't have symptoms.


Prevention & Treatment

Prevention

There is no vaccine to protect you from non-polio enterovirus infection.

Since many infected people do not have symptoms, it is difficult to prevent non-polio enteroviruses from spreading.

You can help protect yourself and others from non-polio enterovirus infections by—

  • Washing your hands often with soap and water, especially after using the toilet and changing diapers,
  • Avoiding close contact, such as touching and shaking hands, with people who are sick, and
  • Cleaning and disinfecting frequently touched surfaces.

Treatment

There is no specific treatment for non-polio enterovirus infection. People with mild illness caused by non-polio enterovirus infection typically only need symptom treatment. They usually recover completely. However, some illnesses caused by non-polio enteroviruses can be severe enough to require hospitalization.

If you are concerned about your symptoms, you should contact your health care provider.