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

High-risk Groups

Pharmacists should be aware of the specific groups, especially children, who are at high risk for contracting EV-D68, including:[7]

  • Children aged ≤4 years

  • Children with a history of respiratory disease (e.g., wheezing, asthma, bronchiolitis), especially those with more severe illness

  • Both children and adults with immunocompromising conditions.

Children with asthma are particularly at risk for severe symptoms from EV-D68 infection. Therefore, if a child has asthma, parents must take steps to prepare in case the child becomes ill with EV-D68. The CDC recommends the following to control a child's asthma during this time:[1]

  • Discuss options to develop and update the child's asthma action plan with his or her physician

  • Educate parents about the importance of adhering to treatment and ensuring the child takes his or her prescribed asthma medications as directed, especially long-term control medications for persistent asthma Children with less severe persistent asthma may require medications such as low-dose inhaled corticosteroids, mast cell stabilizers (cromolyn), and/or an oral leukotriene receptor antagonist such as montelukast (Singulair). More severe illness requires more intense steroidal intervention, and often includes oral therapy. Children with intermittent asthma may be controlled with short-acting bronchodilators used only when needed; however, overall use should be monitored and increased use should be promptly reported to the pediatrician to rule out a more serious respiratory exacerbation[11]

  • Remind parents that the child should receive the annual influenza vaccine, since flu and other respiratory infections can trigger an asthma attack

  • Refer parents and families to their healthcare provider immediately if the child develops new or worsening asthma symptoms

  • Educate caregivers and/or teachers so that they are aware of the child's condition and know how to help if the child experiences any symptoms related to asthma.