The Centers for Disease Control and Prevention (CDC) has issued an update regarding the outbreak of severe respiratory illness caused by the rare Enterovirus D68 (EV-D68) and recommendations for clinicians.

The CDC states that during the period from mid-August to September 16, 2014, 130 individuals from 12 states (Alabama, Colorado, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, New York, Oklahoma, and Pennsylvania) were confirmed to have respiratory illnesses caused by EV-D68. These cases of EV-D68 infection were either confirmed by the CDC or state public health laboratories that notified the CDC. The New York State Department of Health reported on September 12, 2014 that over a dozen children in the state were confirmed to have been stricken with EV-D68; the Connecticut Department of Public Health has received reports on clusters of severe respiratory illnesses among young children from two hospitals in different areas of the state, but these have not yet been confirmed as being caused by EV-D68.

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There is no specific treatment for respiratory illness caused by EV-D68 but clinicians are advised to consider EV-D68 as a possible cause of acute, unexplained severe respiratory illnesses even in the absence of a fever. If the cause of severe respiratory illness is unknown, clinicians should consider laboratory testing of respiratory specimens for enteroviruses to confirm the presence of EV-D68. State health departments can be approached for diagnostic and molecular typing for enteroviruses.

It is estimated that at least 1,000 children have been infected by EV-D68, but specimens are still undergoing testing by the CDC and various states. EV-D68 can only be diagnosed using specific diagnostic tests on specimens collected from the patient’s nose and throat. Prior to sending specimens for diagnostic and molecular testing, clinicians should contact their local or state health department, submit specimens using CDC instructions, complete a specimen submission form, and complete a patient summary form for each patient.

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