The Centers for Disease Control and Prevention (CDC) has issued an update on an outbreak of severe respiratory illness in over 1,000 children in at least 10 states caused by a rare enterovirus. The information has been published in the CDC’s Morbidity and Mortality Weekly Report (MMWR).

The CDC was initially notified of an increase in patients examined and hospitalized with severe respiratory illness (some requiring admittance to the pediatric intensive care unit) at Children’s Mercy Hospital in Kansas City, MO on August 19, 2014. Detections of rhinovirus/enterovirus by a multiplex polymerase chain reaction assay in nasopharyngeal specimens obtained from August 5–19 also increased. The University of Chicago Medicine Comer Children’s Hospital also reported to the CDC an increase in patients with similar profiles to those in Kansas City.

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After nasopharyngeal specimens from both hospitals were submitted to the CDC, Enterovirus D68 (EV-D68) was identified in 19 of 22 specimens from Kansas City and in 11 of 14 specimens from Chicago. Symptoms of enterovirus include mild respiratory illness, febrile rash illness, and neurologic illnesses like aseptic meningitis and encephalitis. However, EV-D68 primarily causes respiratory illness and patients have exhibited rhinitis, sneezing, and coughing. Children with asthma are particularly vulnerable due to the risk of wheezing associated with the virus.

EV-D68 was originally isolated in 1962 and has rarely been reported in the United States. Small clusters of the virus associated with respiratory illness were reported during 2009–2010 but it is unknown how the disease spreads and why it has led to an outbreak as of late. There are no available vaccines or specific treatments for EV-D68, but healthcare professionals are advised to consider EV-D68 as a possible cause of acute, unexplained severe respiratory illness in pediatric patients.

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