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What You Need to Know About Enteroviruses

September 24, 2014
You can’t get on Facebook or Twitter, or even stand in the checkout line at the grocery store without running into a story about enterovirus, more specifically, enterovirus D68. It’s great that parents want to be educated about the viruses going around the globe, and that the media is interested in sharing information, but the level of panic about this virus seems a little out of control.

I’ve seen emails and headlines referring to it as “deadly virus.” As of today, there has not been a death attributed to it. By contrast—according to the CDC—influenza killed just over 1,500 people in 2011 (134 of whom were under 24 years old). Another headline called it a “new virus.” It was actually first identified in 1962. Another said “common cold turns into EV-D68”…a cold is caused by a virus from the start, it doesn’t turn into a virus. EV-D68 can cause the common cold.

In lieu of trying to educate each person online, on Facebook, or commenting on every blog post or email, I thought I would share information with all of our families, and let you be the ambassadors of this knowledge.

Enteroviruses are very common. Every spring and fall, we see large numbers of kids who have symptoms of enterovirus. Since there are over 100 types of enteroviruses, the symptoms can be variable, but typically include:

  • Fever (from low grade, like 99-100, up to high, like 104-105)
  • Rash (can be just on hands or feet or both, or just extremities or face or from head to toe)
  • Pink eye or goopy/watery eyes
  • Runny nose and cough (anywhere from mild to alarming) 
The vast majority of these kids recover completely without any complications. If you have kids who are older than eight years, I would virtually guarantee that they have had an enterovirus infection at some point in their lifetime.

So what’s different now? What has the media in a frenzy? There is a virus going around that seems to be making more kids sicker than average. We now know this is enterovirus D68. It has caused a jump in hospital admissions for respiratory distress at a time of year that we don’t usually see it. In all likelihood, it also causes the milder cold symptoms that people are having. We don’t know for sure, since we aren’t testing patients who aren’t critically ill. If your child has a mild cold, it just isn’t worth $1,000 to find out what virus is causing it.

What You Should Know

  • There are a lot of nasty viruses in the world. Many of them are more prevalent at certain times of the year.
  • Summer and fall are enterovirus season, which is followed by influenza season and RSV season.
  • With any illness, there can be mild cases and severe cases. If your child develops a mild cough, runny nose, and low-grade fever, you can watch him or her at home.
  • In general, there aren’t any medications that can cure viruses or vaccines to prevent them (influenza is a special case; see more info below).
  • A visit to the pediatrician can provide reassurance that your child’s lungs sound clear, the oxygen level in the blood is normal/acceptable, and no respiratory distress is present. However, it will not prevent the virus from worsening, if that’s what the virus is going to do.

What You Can Do

Most of the following information is true for any illness prevention.

  • Wash hands using soap and water for 20 seconds. Hand sanitizer is better than nothing, but some studies suggest that it isn’t as effective at killing enterovirus as a good soap and water scrub. Enteroviruses can be spread by droplet (sneezes and coughs), secretions (sharing cups, wiping boogers), and fecal-oral (not washing well after bathroom, changing diapers).
  • Teach everyone to cough into his or her elbow.
  • Try not to touch your face: Picking your lips or rubbing your eyes increases the likelihood of passing the germs on our hands to our bodies.
  • Clean/sanitize common areas at home and work: counter tops, door handles, etc.
  • Stay home if you or your child are sick. This doesn’t mean you just stay home from work, school, or daycare. Truly, stay at home with no side trips to the grocery store, the gym, or the sale at Macy’s.
  • Get plenty of rest, eat a healthy, well-rounded diet, and stay hydrated.
  • Make sure you have your child’s asthma medications available if they have a history of asthma. The EV-D68 virus in particular, and all viruses in general, can trigger an asthma attack. Knowing your child’s asthma action plan and having medications available could save you a middle-of-the-night ER visit.
  • If this illness has you really worried, you should STRONGLY consider getting the influenza vaccine for your family. The viruses are unrelated and the influenza vaccine won’t protect you from enterovirus, but influenza can cause similar symptoms. Plus, we know that influenza can be deadly and there’s actually a vaccine to try to prevent the infection.

When to See a Doctor

Again, this is true for any illness, not just the EV-D68 virus.

  • If your child is less than 2 months old with a temperature above 100.4, he or she needs to be seen by a medical provider.
  • If your child is having difficulty breathing (grunting, breathing faster and/or more labored than normal, unable to talk in full sentences), sounds wheezy, has color changes (looks pale or blue), he or she needs to be seen urgently. This might mean a visit to the ER in the middle of the night, rather than waiting until morning.
  • If your child seems dehydrated, lethargic, or unusually ill, he or she should be evaluated in the clinic/hospital.

For more specific information on the EV-D68, visit the Centers for Disease Control and Prevention website.

About The Author

Elsa Lee, MD is a pediatrician at St. Luke's Clinic – Treasure Valley Pediatrics.

Related Specialty


Child wellness care and treatment for illness, injury, development issues, and psychological problems.

Related Clinic

St. Luke's Children's Treasure Valley Pediatrics: Meridian
1620 S Celebration Ave
Meridian, ID 83642
(208) 884-1030