The Enterovirus D68 Outbreak: A Public Health Concern

Tammie Lee Demler, BS, PharmD, MBA, BCPP


US Pharmacist. 2015;40(5):22-26. 

In This Article

Neurologic Illness

On September 12, 2014, the CDC was notified by the Colorado Department of Public Health and Environment that a number of children had presented with acute neurologic illness including weakness, cranial nerve dysfunction, diplopia, facial droop, dysphagia, and dysarthria between August and September 2014.[9] The age range of affected patients was reported to be 1 to 18 years, with the median age of 8 years. All had symptoms of febrile illness 3 to 16 days before the onset of neurologic symptoms.

On September 26, 2014, the CDC released a health advisory based on its investigation of the 10 pediatric patients hospitalized as a result of this neurologic illness, noting that this investigation explored the potential link between these symptoms and the EV-D68 viral outbreak.[10] Four of the 8 children tested positive for EV-D68. From mid-August 2014 to January 15, 2015, the CDC or state public health laboratories confirmed a total of 1,153 people in 49 states and the District of Columbia with respiratory illness caused by EV-D68.[1] According to the CDC, almost all of the confirmed cases were among children, many of whom had asthma or a history of wheezing, while millions of others with only mild symptoms of EV-D68 infection did not even seek medical treatment or testing.

Patients aged ≤21 years with acute onset of focal limb weakness that occurred on or after August 1, 2014, as well as an MRI showing a spinal cord lesion restricted to the gray matter, were eligible to be included in this investigation. In most cases, recovery occurred within a few days of supportive care, including intensive care and assisted ventilation.[9]